Reimbursement Manager Job at Eisai
At Eisai, satisfying unmet medical needs and increasing the benefits healthcare provides to patients, their families, and caregivers is Eisai’s human health care (hhc) mission. We’re a growing pharmaceutical company that is breaking through in neurology and oncology, with a strong emphasis on research and development. Our history includes the development of many innovative medicines, notably the discovery of the world's most widely-used treatment for Alzheimer’s disease. As we continue to expand, we are seeking highly-motivated individuals who want to work in a fast-paced environment and make a difference. If this is your profile, we want to hear from you.
Job Summary
The Access and Reimbursement Manager (ARM) will provide appropriate support for patient access to prescribed Eisai products, including through communication with healthcare professionals about insurance coverage and reimbursement for Eisai products and Eisai’s patient support programs. In the event of an access or reimbursement issue, this role will quickly identify and triage, as needed, the situation to appropriate internal or external Eisai partners and manage the communication until appropriate resolution. This role will have a keen understanding of payer coverage at the customer and regional level and strong communication skills to appropriately educate on payer policies. This role will support the Neurology business unit, providing compliant access and reimbursement education to support an Eisai Alzheimer’s product that will necessitate an understanding of buy-and-bill, miscellaneous J Code billing and specialty distribution procurement. The ARM role will be a field-based individual contributor reporting into the Eisai Access and Reimbursement team under Patient Services/Market Access.
Working closely with and reporting to the Associate Director, Access & Reimbursement, the ARM, will be the functional lead for Access and Reimbursement activities across HCP offices, alternate sites of infusion care, State Societies, and Health Systems/institutions.
Key External Stakeholders: Health Care Professionals and stakeholders responsible for physician reimbursement and patient coverage and access issues. These stakeholders include, but are not limited to the following: Practice Mangers, Financial Counselors, Pharmacy Managers/Directors, Business Administrators, State Societies, C and D Suite Health System personnel, and revenue cycle/integrity stakeholders.
Essential Functions
- Consistently demonstrate uncompromised integrity while working cross-functionally and collaboratively with internal and external stakeholders. Strong understanding of legal and regulatory parameters related to patient access and support program services. Comply with all Eisai promotional and administrative policies and applicable law.
- Engage with appropriate individuals in regional accounts, providing them with access and reimbursement insight and/or education consistent with Eisai’s policies.
- Appropriately educate on Eisai patient support programs consistent with Eisai policies. This would include answering questions about Eisai patient support programs and distribution channels to procure Eisai product(s).
- Possess expertise in payer policies across the continuum and educate providers’ office staff, as appropriate.
- Work closely with providers to understand challenges in the patient access process and provide appropriate information to help support patient access to prescribed therapy.
- Communicate field insights to Access and Reimbursement leadership and senior management.
- Appropriately communicate with cross functional colleagues & departments to compliantly exchange information, understand, and share opportunities that could result in the development of solutions to patient access challenges for Eisai products.
- When necessary, travel overnight to assigned accounts, field visits to conferences, training and company meetings.
- Through the access and reimbursement function, the ARM will support Eisai’s human health care mission.
Essential Elements for Success:
- Patient-Focused
- Problem Solver
- Learning Agility
- Priority Setting
- Drive for Results
- Strategic Agility
- Organizational Awareness
- Strategic Planning and Execution Capabilities
- Operating within Ambiguity
Requirements
- BA/BS Degree required
- 7+ years of relevant pharmaceutical or biotech experience required
- At least one year Buy & bill experience with a medical benefit infused product is preferred
- Launch experience with a miscellaneous J Code is preferred
- Understanding of the various elements of Medicare and local MAC policy is preferred
- Demonstrated understanding and experience across various payer segments (Commercial, Medicare, Medicaid and other Federal)
- Previous patient access or reimbursement experience is preferred
- Strong understanding of medical and pharmacy benefit design, coverage policies and reimbursement methodology
- Significant experience working with Patient Support Programs and other patient access and support programs
- Must be able to organize, prioritize, and work effectively to meet deadlines within in a constantly changing environment
- Strong understanding of healthcare regulatory and enforcement environments along with demonstrated integrity on the job.
- Highly organized, strategic thinker with excellent written/verbal communication, and presentation skills
- Demonstrates a high level of emotional intelligence and self-awareness, the ability to excel with multiple objectives simultaneously
- Demonstrated ability to develop relationships with stakeholders and strong collaborator
- Internal candidates only: Will consider a candidate with some buy and bill experience that is less than one year in duration and no access and reimbursement experience as long as the candidate has Alzheimer’s Disease experience.
- Must successfully complete all company training programs and pass the company certification process, as well as all customer mandated and vendor credential requirements
- Valid US driver’s license and a driving record in compliance with company standards
- Must reside within the geography with the ability to travel to support needs to the business – percentage of overnight travel is dependent on geography
- Ability to safely and successfully operate a motor vehicle is required
- Eisai requires all new hires to be fully vaccinated against COVID-19 and provide valid proof of vaccination as of their start date, to the extent permitted under applicable law. This requirement is a condition of employment at Eisai, and it applies regardless of whether the position is located at an Eisai site, field based or is fully remote. If you are unable to receive the vaccine for qualifying medial reasons (including pregnancy-related), or religious reasons (sincerely held religious beliefs), you will have an opportunity to request a reasonable accommodation.
As a condition of employment and an essential function of this field-based position, applicants must be able to engage in person with HCPs and other third parties at their offices, institutions and other appropriate locations on a regular basis. In order to gain in-person access, applicants selected for the position may be required to complete third parties’ credentialing and/or entry requirements, which often include an attestation to and/or providing proof of having received certain vaccinations, including but not limited to the COVID-19 or flu vaccines. To the extent you are unable to meet certain requirements for qualifying medical (including pregnancy-related) or religious reasons, applicants must request a reasonable accommodation by contacting the Human Resources Department.
Eisai Salary Transparency Language:
The base salary range for the Sr. Access & Reimbursement Manager, Orlando, FL is from :$153,500.00 - $230,300.00
Under current guidelines, this position is eligible to participate in : Eisai Inc. Annual Incentive Plan.
Employees are eligible to participate in Company employee benefit programs. For additional information on Company employee benefits programs, visit
https://us.eisai.com/careers-at-eisai/benefits
.
Certain other benefits may be available for this position, please discuss any questions with your recruiter.
Eisai is an equal opportunity employer and as such, is committed in policy and in practice to recruit, hire, train, and promote in all job qualifications without regard to race, color, religion, gender, age, national origin, citizenship status, marital status, sexual orientation, gender identity, disability or veteran status. Similarly, considering the need for reasonable accommodations, Eisai prohibits discrimination against persons because of disability, including disabled veterans.
Eisai Inc. participates in E-Verify. E-Verify is an Internet based system operated by the Department of Homeland Security in partnership with the Social Security Administration that allows participating employers to electronically verify the employment eligibility of all new hires in the United States. Please click on the following link for more information:
Right To Work
E-Verify Participation
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