Access & Reimbursement Manager, Sleep

Job Description:

• Execute the Xywav market access business plan for the assigned geography
• Work with provider offices and outpatient care centers to educate providers and staff on payer and reimbursement policies and procedures
• Provide expertise on the REMS program and patient support services
• Collaborate with Field Sales, Sales Management, Patient Support Services, Managed Markets, Trade & Distribution, internal commercial teams, and other cross-functional partners
• Develop relationships with key personnel, targeted physicians, office managers, and staff in key customer accounts
• Provide billing and coding education within compliance
• Ensure REMS provider and patient enrollment and education on REMS processes and requirements
• Implement strategies that achieve Business Unit and Corporate goals and objectives
• Analyze data and develop action steps
• Establish and maintain strategic relationships with assigned providers and provider accounts
• Educate offices on coding, billing, payer prior authorization requirements, and patient access services
• Collaborate with sales teams to develop payer and reimbursement action plans
• Monitor, document, and communicate coverage policy changes
• Maintain payer coverage and reimbursement database
• Educate customers on commercial payers, state Medicaid agencies, managed Medicaid organizations, HMOs, pharmacy benefit organizations, health care plans, GPOs, DOD, and Veterans Integrated Service Networks
• Conduct annual business development reviews and required updates
• Provide managed care and reimbursement training and educational activities
• Represent Jazz at payer, reimbursement, policy, and professional organization meetings
• Plan territory priorities and manage time for the assigned geographical area
• Maintain accurate expenses, reports, correspondence, and records
• Execute activities within Jazz’s regulatory and compliance program
• Maintain company manuals, reports, computer systems, records, brochures, computers, and other assigned equipment

Requirements:

• BA/BS Degree (MBA preferred)
• At least 5 years of pharma, biopharmaceutical, and/or medical device experience calling on field based customers with demonstrated successful track record
• Account Management and/or Reimbursement experience working in the provider office setting, building strong customer relationships
• Experience working with HUB, Patient Services, and/or REMS programs
• Experience working with Integrated Health Systems-- preferred
• Managed Care and Reimbursement Knowledge --preferred
• Experience in building a team atmosphere with sales representatives, either with direct or indirect leadership authority
• Ability to make sound decisions within time/resource constraints
• Proven skills in strategic decision-making and problem-solving
• Excellent analytical skills focusing on key accounts and uncovering business opportunities
• Experience working with billing and medical claims personnel in healthcare settings preferred
• Proficient with MS Office including Excel, Word, PowerPoint preferred
• Candidates should live near a major airport and be willing and able to travel approximately 70-75% of the time (average 3-4 days per week)
• CPC, or similar coding certification preferred, not required

Benefits:

• Discretionary annual cash bonus or incentive compensation
• Discretionary equity grants
• Medical insurance
• Dental insurance
• Vision insurance
• 401k retirement savings plan
• Flexible paid vacation