Position Summary

The Market Access Field Reimbursement Manager (FRM) (South Central Region and Florida) will proactively engage with the ADMA Biologics field force to provide education and support to provider, their offices, and support staff on ADMA HUB Patient Support Program and services, national and regional payor coverage, policy, and criteria. This role serves as the key contact for field-based reimbursement and access support-related matters and is responsible for being the local market access expert on payer, policy, and processes to help providers navigate coverage and help support patients in obtaining coverage.

Essential Functions (ES) and Responsibilities

· Provide clear and detailed coverage, criteria and policy education to healthcare provider offices, physician owned infusion suites, ambulatory infusion suites, National and Regional Specialty pharmacies/Home Infusion providers and hospital-based outpatient infusion centers.

· The (FRM) will work with the ADvantage Ig Patient Support Program (HUB) to help ensure clear and transparent communication between providers and ADMA.

· Communicate technical knowledge of patient enrollment, prior authorizations, appeals, and ADMA Biologics sponsored HUB support programs.

· Serve as the market access training lead for respective territory, delivering policy updates and program information as needed.

· Collaborate in cross-functional meetings with Sales, Market access, and Medical Affairs as needed to help support providers.

· Maintain compliance with PHI/HIPAA and company policies.

· This role will cover the Central region and will be responsible for the central United States, as well as covering additional regions as needed.

· This is a remote role and travel within your region and national meeting will be approximately (65-75%).

· The FRM will have responsibility in supporting Providers and Sales in the following states:

•  Texas
•  New Mexico
•  Oklahoma
•  Arkansas
•  Louisiana
•  Florida

Job Responsibilities or Job Requirements

Competencies

Experience Requirements

· 10 years of experience working for a major pharmaceutical organization on the field reimbursement team, understanding different site of care provider segments and payors, i.e., (Commercial, Medicare, Medicaid, VA/DOD/Tricare, and ACA) as well as a deep understanding of the Medical and Pharmacy benefits, billing and coding practices for infused products is required.

· Extensive frontline experience working with and across the various infusion service areas within the US health care system. Specifically, Physician Buy and Bill offices, Ambulatory Infusion suites, National and Regional Specialty Pharmacies/Home Infusion Providers and hospital owned outpatient infusion centers.

· Must be able to understand and clearly disseminate payor policy and criteria for coverage in the medical and pharmacy benefit to existing and future providers.

· Must be able to think independently, analyze issues and make recommendations that will help providers and patients obtain coverage to start therapy.

· Must have extensive Buy and Bill experience in Rare Disease, Plasma/IVIG, Oncology or Orphan Disease.

· Strong understanding of healthcare regulatory and enforcement environments along with demonstrated integrity on the job.

· Employees are responsible for ensuring compliance with all ADMA Quality policies, standards, and SOPs in their area of work and responsibility. This includes ensuring all Quality Assurance (QA) records and reports, Human Resources (HR) policies, and Environmental Health and Safety (EH&S) procedures and practices are completed in a timely manner.

· Must be Proficient in Microsoft Office, Excel, and PowerPoint and Teams.

· Strong people skills.

· Excellent written and verbal communication skills.

Preferred Experience

Education Requirements:

· BA/BS/RN degree required, preferably in life science, business, or nursing, master’s degree a plus. RN is highly desirable.

Compliance Requirements (ES)

Maintain compliance with PHI/HIPAA and company policies.