The Associate Director, Field Reimbursement Specialist (FRS) is primarily responsible for implementing reimbursement information assistance to provider offices who are seeking to obtain product coverage. This individual works cross-functionally and collaboratively with the Hub, Pharmacy, Market Access, Commercial Organization and Operations teams. In addition, the Associate Director, Field Reimbursement Specialist plays a critical role in providing timely feedback, recommendations and informatio... more details
At MannKind our employees are our number one asset, and we continue becoming a tight-knit community where each of us plays a critical role in our collective success. Committed to diversity, at MannKind we depend on a rich blend of ideas, backgrounds, and working styles in our quest to change the world for the better.
Position Summary:
The Associate Director, Field Reimbursement Specialist (FRS) is primarily responsible for implementing reimbursement information assistance to provider offices who are seeking to obtain product coverage. This individual works cross-functionally and collaboratively with the Hub, Pharmacy, Market Access, Commercial Organization and Operations teams. In addition, the Associate Director, Field Reimbursement Specialist plays a critical role in providing timely feedback, recommendations and information assistance on account and case management.
Core Responsibilities:
- Coordinates access and reimbursement issues with third parties including Hub and Patient Support Services to deliver reimbursement information assistance to customers.
- Apply a deep understanding of each customers environment and actively engage them with the intention of improving information assistance and enhancing the ability of provider offices to handle reimbursement effectively and efficiently.
- Act as the sole exclusive MannKind (MNKD) point of contact for the Hub, pharmacy, and patient support service providers, and provide the minimum necessary level of communication with field sales regarding account status.
- Must always be diligent about protecting patient privacy and any protected Health Information received.
- Leads the planning process for assigned geography that aligns with overall MNKD goals for helping to ensure that healthcare providers and patients are not faced with avoidable and unreasonable hurdles when attempting to access drug therapy prescribed by their physician.
- Develops account plans with consideration of customer, market, industry, and organization needs.
- Coordinates closely with MNKD Field Sales and Market Access, gaining knowledge of the health insurance marketplace within their assigned geography and then develops specific plans to provide information assistance with reimbursement as necessary.
- Responsible for developing collaborative relationships with external and internal customers that include physician offices, pharmacy partners and the Hub, and for compliant coordination and communication with Market Access and Sales.
- Provide information assistance to prescriber office staff related to working with the Hub and the specifics of payer coverage requirements, including but limited to the ability to address questions about coverage details, ICD-10 codes, specific product codes, including patient-specific access questions.
- Coordinate with Market Access when necessary, on all Prior Authorization requirements and reimbursement denials generated by Market Access accounts.
- Ensure that educational, informational, and other resources that are utilized in the provision of reimbursement support to physician offices have been appropriately identified and are efficiently utilized.
- Integrate market information into reimbursement support activities, anticipating and adapting to changing market conditions and priorities, and utilizing a sophisticated understanding of potential obstacles to therapy through the application of available Field Reimbursement and Hub resources.
- Implements the strategies developed to ensure information assistance is provided through effective management of all resources.
- Other duties may be assigned.
Education and/or Experience:
- Bachelors degree required with minimum of 12 years of industry specific experience OR Masters Degree with 11 years of industry specific experience OR PhD with minimal of 5 years of industry specific experience
- Minimum 5 years of related experience in patient journey navigation, specialty pharmaceutical/biotech reimbursement with a strong understanding of managed care, payer and reimbursement landscape, hub and patient support services engagement, medical billing & coding, pharmacy distribution, pharmacy benefits managers and government payers and their impact of product access. This should include experience as a sales representative and / or account manager (combined 5 years).
- Other commercial experience (i.e., Market Access, Training, Marketing, etc.) is preferred.
- Experience in diabetes and insulin preferred
- Experience in IDNs and Health Systems preferred
- In-depth knowledge of pharmaceutical manufacturer compliance requirements, patient confidentiality (HIPAA regulations), product reimbursement and product access requirements
- In-depth understanding of Patient Enrollment Forms, Prior Authorization process; Appeals; Peer to Peer interventions; coding; coverage and payment across all sites of care (e/g/. office, clinics, hospital)
- Ability to identify, understand, and educate on resolutions to access barriers with both specialty pharmacy products and medical benefit products
- Ability to problem solve on complex issues
- Strong communication (verbal and written) and collaborations skills
- Effective presentation skills one-on-one and large groups
- Ability to analyze data, dashboards, and Excel spreadsheets
Preferred Qualifications/Skills:
- Current, in-depth knowledge of current trends in reimbursement modalities
- Demonstrated ability to develop, communicate, and implement successful initiatives
- Ability to analyze reimbursement and access issues and act as the local access and reimbursement resource expert for field sales personnel and region management
- Coordinate with the hub, pharmacy and patient support service providers concerning individual patient cases including patient reimbursement assistance, and overall patient journey
- Proven leadership skills and strong business acumen
- Well-developed relationship management and consultative skills
- Demonstrated ability to thrive in a dynamic, fast-paced environment
- Strong project management and analytical thinking skills
- Demonstrated initiative, and strategic relationship building
- Self-directed and confident, with developed ability to build teamwork centered on shared commitment and goals to achieve high standards of performance
- Must be proficient in MS Office Suite
- Certificates, Licenses, Registrations
- Must have a valid and current driver's license and current auto insurance
Physical Demands:
- The physical demands here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
- The Associate Director, Field Reimbursement is required to travel extensively to work with Customers, the Hub and Market Access; the average travel for this position is 50% with some variation based upon the demands of the business imperatives.
- While performing this job, this individual will be required to frequently drive or fly. Occasional travel to internal meetings and corporate headquarters is also required.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed above are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
MannKind Corporation (NASDAQ:MNKD) focuses on the development and commercialization of inhaled therapeutic products for patients with diseases such as diabetes and pulmonary arterial hypertension. MannKind is currently commercializing Afrezza (insulin human) inhalation powder, the Company's first FDA-approved product and the only inhaled rapid-acting mealtime insulin in the United States, where it is available by prescription from pharmacies nationwide. MannKind is headquartered in Danbury, Connecticut where it has a state-of-the-art manufacturing facility. The Company also employs field sales and medical representatives across the U.S. For further information, visit www.mannkindcorp.com.
Mannkind Corporation is proud to be an Equal Employment Opportunity employer. We provide equal employment opportunity (EEO) to all persons regardless of race, creed, color, religion, national origin, ancestry, gender (including pregnancy, breastfeeding or medical condition related to pregnancy or breastfeeding), age, physical or intellectual disability, sexual orientation, gender identity, gender expression, gender stereotyping, marital status, military or veteran status, citizenship, genetic characteristic or information, or any other characteristic protected by applicable federal, state, or local law.
