Position Summary

This role is responsible for representing ADMA Biologics at national, regional, and state-level conferences, industry meetings, provider educational programs, reimbursement forums, and customer engagements throughout the U.S.

This individual will attend in person all major national and regional immunology, allergy, infusion, specialty pharmacy, and rare disease conferences relevant to ADMA Biologics throughout the year and will spend the majority of their time traveling throughout the U.S. 

The NC-FRM will maintain a highly visible presence at major immunology, allergy, infusion, specialty pharmacy, and rare disease conferences throughout the year. Through these interactions, the NC-FRM will provide education on coverage requirements, prior authorization processes, billing and coding considerations, payer policy trends, and patient support services available through the ADvantage Ig Patient Support Program.

Essential Functions (ES) and Responsibilities

• Represent ADMA Biologics at national, regional, and state-level conferences, congresses, and industry meetings throughout the United States.
• Serve as ADMA's field-based reimbursement and access expert for ASCENIV and BIVIGAM at conferences, educational programs, and provider engagements.
• Educate healthcare providers and reimbursement stakeholders on coverage, reimbursement, and patient access considerations for ASCENIV and BIVIGAM.
• Conduct reimbursement-focused discussions with physicians, infusion providers, specialty pharmacies, office staff, and practice administrators.
• Provide education regarding payer requirements, prior authorizations, appeals, billing and coding, claims submission processes, and patient support resources.
• Support conference exhibits, educational programs, reimbursement workshops, advisory boards, and provider events.
• Develop and maintain relationships with key stakeholders involved in patient access and infusion therapy delivery.
• Gather and communicate market intelligence regarding payer trends, reimbursement challenges, customer needs, competitive activities, and treatment trends.

• Serve as the reimbursement and market access subject matter expert for ASCENIV, BIVIGAM, and ADMA Biologics patient support programs.
• Educate providers on medical and pharmacy benefit coverage requirements across commercial and government payers.
• Interpret and communicate payer policy updates and reimbursement changes that may impact patient access.
• Promote appropriate utilization of ADMA HUB services and reimbursement support resources.
• Partner closely with Sales, Market Access, Medical Affairs, Patient Services, and Commercial teams.
• Share field insights and reimbursement intelligence gathered through conference and customer interactions.
• Participate in internal training initiatives and provide reimbursement-related updates to field teams.
• Support business initiatives focused on improving provider education and patient access.

Job Responsibilities or Job Requirements

Competencies

Experience Requirements

• Education Requirements: Bachelor's degree required, preferably in Life Sciences, Nursing, Healthcare Administration, Business, or a related field. RN, PharmD, MBA, or advanced degree would be preferred and is a plus.

• Experience Requirements: 

  • Minimum of 10 years of pharmaceutical, biotechnology, specialty therapeutics, healthcare reimbursement, or market access experience.
  • Significant field reimbursement experience supporting provider offices, infusion centers, or specialty therapies.
  • Extensive knowledge of Commercial, Medicare, Medicaid, Managed Medicaid, ACA Exchange Plans, VA/DOD, and TRICARE reimbursement structures.
  • Deep understanding of medical and pharmacy benefit reimbursement, coverage determinations, billing and coding practices, and payer policy interpretation.
  • Experience supporting infused and specialty-administered therapies within physician offices, ambulatory infusion centers, specialty pharmacies, home infusion providers, and hospital outpatient infusion centers.
  • Demonstrated expertise in prior authorizations, appeals, claims adjudication, reimbursement support, and patient access programs.
  • Experience within Immunology, Rare Disease, Plasma/IVIG, Specialty Biologics, Oncology, or other specialty therapeutic areas.

Preferred Experience

Compliance Requirements (ES)

The minimum compliance expectation for this role entails strict adherence to FDA regulations and company policies governing sales and marketing activities. This includes completion of required compliance training, accurate documentation of sales interactions, and adherence to data privacy regulations. Additionally, the role requires proactive participation in compliance reviews, prompt reporting of any potential issues, and ongoing education to stay updated on relevant FDA regulations.