Patient Access and Reimbursement Manager

Company: Tolmar Pharmaceuticals, Inc.
Location: Buffalo Grove
Posted on: January 15, 2022

Job Description:

Purpose and ScopeThe Patient Access and Reimbursement Manager (PARM) is a critical front-line member of the Tolmar Access and Reimbursement team who represents Tolmar's interest with Eligard and Fensolvi with HCP accounts, as well as all internal Tolmar stakeholders and field sales personnel. The PARM will be an expert and provides education, training and hands-on assistance related to access of Tolmar products.Essential Duties & Key AccountabilitiesProvider Account Support

• Critical point person for all reimbursement and acquisition logistical aspects of a high touch Central Precocious Puberty medication for a rare disease with controlled acquisition options within a changing payer landscape.
• Assists HCP offices with questions related to Buy/Bill management. Educate/Assist with Specialty Pharmacy (SP) understanding, expectations and logistics. Continually educate office staff on appropriate steps, educate on the importance of chart documentation, keep offices up to date on payer policies for Tolmar products and triage issues to the appropriate HUB and SP.Primary responsibilities include:
  • Managing patient assistance and reimbursement support services offered to providers and related to patient access to buy/bill and SP products.
  • Coordinating with Tolmar's patient support services program representatives.
  • Educating office staff on the use of Buy/Bill and SP products, patient assistance and reimbursement support services.
  • Participating in sales training related to product reimbursement.
  • Utilizing data to think critically through acquisition challenges from a variety of outlets including SP, Specialty Distributors and Mainline Distributors.
  • Assist new offices to inform them about reimbursement issues as well as providing education on various MRL approved resources pertaining to reimbursement, acquisition and coding.
  • Ensures all actions taken create a positive impact on the patient journey and the brand experience in a compliant manor.Specialty Pharmacy Support
    • Work closely with the external and internal customers to trouble shoot SP related issues. PARM work closely with their Director of Access to manage customer related issues directly with the SP's.
    • PARM should have an expert level of knowledge pertaining to SP logistics and operations.
    • PARM must be able to analyze data and know how to make that data into actionable steps to facilitate patient access to Eligard and Fensolvi.
    • Work closely with SP's to understand logistical issues that arise and provide MRL approved resources and programs to facilitate patient access as well as communicate with SP's to find resolutions to issues that arise at the SP.
    • Identify gaps in account knowledge of the SP process and provide education/resources to fill those gaps and improve the account and physician experience.
      Internal Partnerships
      • Consistent, reliable, timely and high-quality support of the field, as well as all other internal commercial functions.
      • Strong leadership role to the field teams by establishing a solutions oriented approach, working with your Account Managers (AMRs) and Directors of Corporate Accounts (DCAs) to build and execute local plans to overcome barriers to Eligard and Fensolvi access.
        • Specific examples include:
          • Identify in conjunction with the field, specific targeted accounts where the PARM will assist with product acquisition or SP dispense.
          • Collaborate with AMRs, RSDs, and DCAs to build local business plans; participate in district business reviews as the expert resource on the reimbursement landscape from regional, district, state and local perspective.
          • Provide the leadership team with actionable feedback (across the organization) on support programs such as the bridge program, copay card, SPP performance, to guide changes to improve access.
          • Provide internal customers updates on changes in managed market dynamics specific to SP's/SD's/MDs as well as local payer issues-needs. Track customer trends in order to help inform internal business decisions, e.g. Health care policy changes.
          • Proactively collaborate with business analytics to understand common logistical issues in top accounts and proactively develop plans for education and to find solutions for better patient access to Eligard and Fensolvi. Ensure alignment with Vice President of Sales and Regional Directors.
          • Provide support to AMRs, RSDs, DCAs and Internal Stakeholders on rules of engagement to educate and further clarify what is appropriate.Advocacy
            • Works with the field to identify potential payer advocates and supports the Access team on issues relating to medical policy development and execution at the HCP level.
            • Ensure all Tolmar approved promotional speakers have an in-depth understanding of billing/coding, logistics and payer coverage.Knowledge & Qualifications
              • BS or equivalent is required, MBA or advanced degree ideal.
              • 5-7 years of relevant experience in the Biopharma industry required.
              • Previous experience working with vendor relationships preferred.
              • Previous experience managing customer interactions.
              • Previous sales management and/or account management experience highly desirable.Working Conditions
                • Office environment; requiring sitting and standing.
                • Travel as required.
                  Equal Opportunity Employer/Protected Veterans/Individuals with DisabilitiesThe contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)

Keywords: Tolmar Pharmaceuticals, Inc., Buffalo Grove , Patient Access and Reimbursement Manager, Executive , Buffalo Grove, Illinois