Field Reimbursement Manager Tzield, Chicago Il
Principia Biopharma, Inc.
Sanofi General Medicines is currently expanding a newly formed patient services team to support the launch of Tzield, an innovative therapy for people at risk of developing clinical-stage type 1 diabetes. This is a great opportunity to join a new and growing function and help shape the future of one of the most cutting-edge therapies in the industry today.
The individual in this role will need to demonstrate a deep passion for patients and caregivers with an emphasis on enhancing and optimizing the prescriber experience with our support program offerings. Moreover, since this is a foundational role, this individual will need to quickly establish compliant relationships with providers and team matrix, helping to ensure successful access to the prescribed treatment.
This is a field-based position that provides reimbursement education and support for customers that utilize TZIELD (and other future products). You will act at the subject matter expert on access, reimbursement, billing and coding processes and providing support through (1) product-specific provider reimbursement support, (2) coordination of HUB/Patients Services reimbursement services, and (3) managing payer/coverage pull-through initiatives. Lastly, to be successful in this role, strong and compliant cross-functional collaboration with Sales, other commercial team members, and market access is essential.
Primary responsibilities include but are not limited to:
Work closely with Patient Services Support functions to coordinate activities in support of patient access
Partner with Field Sales, Case Management and Market Access teams to ensure close matrix collaboration
Work closely with providers to gain access to therapy
Be the main point of contact for providers in the assigned geography for reimbursement related needs.
Back-up colleagues and collaborate across patient services team
Successfully and compliantly support providers in enrolling patients into the program and providing follow up to support reimbursement/ approval of therapy
Communicate during the Benefit Verifications process and follow-up for timely prior authorization and appeal completion
Manage general inquiries via phone or email or in person
Work with specialty pharmacies and specialty distributors
Coordinate with different sites of care, including infusion centers
Support the transition from infusion site to in-home infusion therapy as appropriate
Maintain customer engagement activities in the CRM system
Troubleshoot and resolve ongoing reimbursement issues (insurance changes, PAs, other)
Record and report Adverse Events and Product Complaints
Respond to replacement requests from HCPs
Proactively communicate specific patient support offerings, utilizing MLR-approved materials
Schedule time with HCPs in the field or over Zoom to educate and/or work through reimbursement challenges
Educate HCPs and staff on product procurement through SP or Buy/Bill, site of care, and billing/coding
Inform HCPs and office staff of approved billing and reimbursement information using MLR-approved items (J-codes, EOBs, co-pay programs, etc.)
Provide HCPs with compliant information and coverage guidance to help address coverage and reimbursement matters
Stay educated about and strictly adhere to compliance and OIG guidance and policies regarding patient support programs and offerings
Establish and maintain knowledge on the local and national payer landscape, including Specialty Pharmacy and Utilization Management criteria for TZIELD
Reactively address access and reimbursement issues and provide necessary education for them to secure appropriate reimbursement and access
Provide approved information related to product coverage, which may include payer specific requirements for claims processing, information regarding prior authorizations and the appeals process, as well as general information regarding disease state
Interact regularly with Tzield Sales Force (KAMs), Case Mangers, Regional Account Directors to provide field intelligence and disseminate payer policy and positive advantage
Serve as a primary point of contact for Market Access team for distribution of information and payer issues
Work & coordinate with the HUB/Patient Services Director to educate customers on appropriate available patient support programs. Explain financial assistance and other funding options available for TZIELD patients
Help the practice understand how to enroll patients in appropriate programs.
Attend meetings and represent Sanofi at industry conference
Travel to national meetings and medical offices as needed
Bachelor’s Degree (general business, health sciences, public policy, or other related degrees) required
Experience with new product launches, especially in rare diseases or specialty
Infusion product and/or specialty product experience (i.e. medical benefit coverage)
5-10 years of prior case management experience or healthcare experience
5-10 years of prior field reimbursement manager experience
Reimbursement experience and strong understanding of health insurance and benefits, co-pay assistance programs, Medicare, Medicaid, and private payer policies
Strong listening, verbal, and written communications skills
Detail orientated and highly organized
Ability to multi-task in a fast-paced environment
Patient-centric and service-oriented mindset
Team orientated with proven experience compliantly partnering with commercial sales, market access, and other stakeholders
Bilingual desired, but not required
Candidates must complete all fleet safety training and must maintain an acceptable driving record regarding accidents and incidents.
Sanofi Inc. and its U.S. affiliates are Equal Opportunity and Affirmative Action employers committed to a culturally diverse workforce. All qualified applicants will receive consideration for employment without regard to race; color; creed; religion; national origin; age; ancestry; nationality; marital, domestic partnership or civil union status; sex, gender, gender identity or expression; affectional or sexual orientation; disability; veteran or military status or liability for military status; domestic violence victim status; atypical cellular or blood trait; genetic information (including the refusal to submit to genetic testing) or any other characteristic protected by law.
The salary median compensation and range for this position is $154,875. All compensation will be determined commensurate with demonstrated experience. Employees may be eligible to participate in Company employee benefit programs. Additional benefits information can be found through the link, www.benefits.sanofiusallwell.com
At Sanofi diversity and inclusion is foundational to how we operate and embedded in our Core Values. We recognize to truly tap into the richness diversity brings we must lead with inclusion and have a workplace where those differences can thrive and be leveraged to empower the lives of our colleagues, patients and customers. We respect and celebrate the diversity of our people, their backgrounds and experiences and provide equal opportunity for all.ID:uDnQdo