Alimera Sciences

Reimbursement Account Specialist - West Coast

US-CA
3 weeks ago
ID
2017-1122
# of Openings
1
Category
Managed Markets

Overview

**Based in California**

 

In this field based position, the Reimbursement Account Specialist will report to the Director of Reimbursement.  The RAS will be the field subject matter expert relating to billing and coding education and responsible for the management of practice level reimbursement and access for ILUVIEN.  The RAS will help support ILUVIEN reimbursement through the development of relationships with Practice Administrators/Managers, Billing Managers/staff and regional thought leaders.  In addition, the RAS will work closely with the ILUVIEN Reimbursement Hub, AccessPlus, to provide comprehensive support and assistance to physician practices and institutional accounts for coverage, reimbursement and access guidance for ILUVIEN case management.  The RAS will work directly with the Regional Sales Director and Sales team to develop action plans to prioritize and maximize optimal access across sales regions.  The RAS will also collaborate closely with the Payer Relations Director team regarding local and regional coverage and policy decisions, resolution of payer related issues, and specialty pharmacy access within the assigned geography. In addition, these positions will provide critical competitive intelligence on business trends within key accounts and coverage trends with local, regional and national payers.  The ultimate goal of the position is to maximize reimbursement confidence for ILUVIEN, minimize ILUVIEN access barriers and promote/implement various programs and services to supplement the field sales force and management efforts.

Responsibilities

  • The Managed Markets & Reimbursement department will include (4) field based Payer Relations Directors and (6) Reimbursement Account Specialists and will support (4) Sales Regions within the commercial organization.
  • The Reimbursement Account Specialist (RAS) will be the subject matter expert on product procurement as it relates to the buy & bill process, specialty pharmacy process, reimbursement (billing and coding) education, financial assistance options for ILUVIEN, and issue resolution pertaining to the purchase, billing and reimbursement of ILUVIEN.
  • The RAS will work closely with the ILUVIEN Reimbursement Hub team (AccessPlus) to provide guidance, expertise and pull-through/follow up for individual case management, office level and institution based reimbursement support in order to instill critical reimbursement confidence within the retina community to support ILUVIEN.
  • The RAS team, in conjunction with the Payer Relations Director team, will be responsible for optimizing pull-through of the managed markets strategy at the local and regional level, monitoring managed care, reimbursement and policy activities, as well as business trends relevant to Alimera Sciences and ILUVIEN.
  • The RAS will establish crucial relationships with a variety of stakeholders within their geography: Practice Administrators, Practice Managers, Billing Managers and billing staff, and Retina Specialists; will also work with relevant advocacy, state, institutional, society and other associations and organizations to enhance awareness and support ILUVIEN.
  • The RAS will work closely with sales team to prioritize business and reimbursement needs and to communicate as needed on payer issues and payer-specific strategies.
  • Educate, train and support the regional sales team on all reimbursement needs for cross-functional support.
  • Proactively identify potential marketplace trends/barriers within respective geographies regarding ILUVIEN.
  • Reactively respond to any identified reimbursement, coverage issues and market access challenges for ILUVIEN within their geographies.
  • Provide marketplace surveillance and analysis on ILUVIEN access issues and competitive landscape.

Qualifications

  • Knowledge in managing various market segments including: product distribution and acquisition, reimbursement and coverage, patient access and financial assistance, health plans/federal marketplace, and physician networks.
  • Strong knowledge and understanding of the commercial payer landscape and policy activity, Medicare Part B, Medicare Advantage plans, Medicare Supplemental plans and Medicaid (fee for service and managed plans).
  • In-depth knowledge of managed care, state, federal and reimbursement sectors.
  • Strong understanding and experience supporting physician-administered products, especially in the provider office setting of care.
  • Expert problem solving skills with a demonstrated team orientation.
  • Demonstrated ability to manage multiple situations and excellent ability to prioritize work with a sense of urgency.
  • Demonstrated leadership skills and ability to lead without authority with internal and external stakeholders.
  • Ability to work, lead and influence cross-functionally within various departments, with an emphasis on the sales department.
  • Demonstrated ability to work in a fast paced, entrepreneurial environment.
  • Excellent verbal and written communication skills.
  • Ability to function as a self-starter with a high level of energy and drive for success.
  • Ability to rapidly assimilate information.
  • Ability to prioritize and manage to timelines.
  • Ability to cultivate spheres of influence.
  • Strong interpersonal skills.
  • Ability to multi-task.
  • Ability to travel up to 30% or as business dicatates.

 

EDUCATION and EXPERIENCE:

 

Required:

 

  • Minimum of 10 years experience in the pharmaceutical/biotech industry.
  • Minimum 2 years experience in a practice facing, field based reimbursement role providing billing and coding education, coverage and policy guidance, follow up and issue resolution pertaining to the purchase, billing and reimbursement of a physician-administered product.
  • Reimbursement-oriented launch experience or involvement with the launch for a physician-administered product.

 

Strongly Preferred:

 

  • Successful sales background with strong account management experience.
  • Integral involvement with the launch of a buy and bill product.
  • Experience in the Retina specialty.  
  • Billing and Coding certification.

  

SUPERVISORY RESPONSIBILITIES:

 

  • Territory management responsibilities for assigned geography.

 

 

 

 

Alimera Sciences, Inc. is an equal opportunity employer EEO/AA and strongly supports diversity in the workplace. All qualified applicants will receive consideration without regard to race, color, religion, sex, national origin, status as a qualified individual with a disability or Vietnam era or other protected veteran. M/F/V/D

 

 

 

 

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