Access and Reimbursement Manager

About the Company

Omeros is an innovative biotechnology company that discovers and develops first-in-class protein and small-molecule therapeutics for both large-market and orphan indications, with a focus on complement-mediated diseases, cancers, and addictive or compulsive disorders. Omeros’ lead complement inhibitor YARTEMLEA® (narsoplimab-wuug) is FDA-approved and commercially available in the U.S. for the treatment of hematopoietic stem cell transplant-associated thrombotic microangiopathy (TA-TMA) in adult and pediatric patients aged two years and older. The company’s pipeline includes OMS1029, OMS527, zaltenibart (licensed to Novo Nordisk), and a growing portfolio of novel recombinant antibodies and molecular/cellular therapeutic programs for oncology and multidrug-resistant organisms.

Responsibilities

• Educate inpatient and outpatient billing, coding, office managers, and other care team members on coding, claim submission, payer policies, and reimbursement to optimize access to Omeros therapies.
• Proactively educate accounts on patient support services and resources; partner with the HUB patient program to support efficient patient initiation and continuation of treatment across sites of care.
• Monitor, analyze, and triage situations that may adversely impact patient access to therapy; provide timely feedback to internal and external customers.
• Collaborate cross-functionally with Omeros field teams—including Sales, Market Access, Patient Support, and Medical—to develop and execute account strategies that support timely patient access, consistent education on reimbursement, and address barriers to treatment.
• Execute account-specific reimbursement initiatives, educational programs, and support services that optimize patient access, strengthen customer confidence in the reimbursement process, and facilitate timely treatment for eligible patients.
• Proactively communicate Omeros-specific reimbursement programs, coding/billing policies, and resources to healthcare provider (HCP) personnel related to access.
• Apply strong problem-solving and time management skills to identify and implement solutions addressing reimbursement and patient access challenges for healthcare providers, reimbursement professionals, and coding staff.
• Establish relationships with key institution/hospital, physician office, specialty pharmacy, and other personnel associated with coding, billing, access readiness, treatment initiation, and reimbursement.
• Comply with all federal, state, and local laws, regulations, and guidelines, including the PhRMA Code on Interactions with Healthcare Professionals, as well as Omeros standards and policies.
• Perform other duties as assigned.

Requirements

• BA/BS degree with at least 7–10 years of pharmaceutical experience.
• Preferred minimum of 5 years’ experience in reimbursement/payer access.
• Experience with buy and bill is required.
• Product launch experience in the U.S.; experience in oncology/hematology/transplant and/or ultra-rare disease is highly desirable.
• Experience with limited distribution networks, specialty pharmacy, and/or HUB models is preferred.
• Advanced understanding of healthcare, payers, hospital formulary, coverage, reimbursement issues, specialty pharmacy state laws, and compliance laws and regulations.
• Demonstrated high proficiency in communication skills, critical thinking, decision-making, influence, problem-solving, planning, and organization.
• Clinical knowledge in one or more of the following therapeutic areas preferred: Oncology, Hematology, Blood and Marrow Transplant.
• Strong background in products on the medical benefit and how that impacts reimbursement by different payer types (Commercial, Medicare, Medicaid).
• Demonstrated ability to work collaboratively with Sales, Marketing, Market Access, and National Accounts teams to ensure product access.
• Strong communication and educational skills with both internal and external customers that result in product access.
• Strong verbal and written communication skills to provide updates, direction, information, and clarification in a timely manner.
• Strong Microsoft Office skills (Excel and PowerPoint).
• Strong analytical skills.
• Travel requirement: 50–80%.

Behavioral Competencies

• Demonstrated ability to build and maintain positive relationships with management and peers.
• Operate with integrity, trust, and honesty.
• Ability to address and manage conflicts with internal and external customers.
• Demonstrate positive working relationships through emotional intelligence at various levels of the organization.
• Ability to be flexible and manage change within a dynamic, growing organization and an evolving healthcare marketplace.

Pay

The wage scale for this position is $185,000 – $210,000, determined based on knowledge, skills, education, and experience relevant to the role.

Benefits

• Medical, dental, and vision insurance.
• Life insurance.
• 401(k) plan with company match.
• Three weeks of vacation and 80 hours of sick time accrued annually.
• Twelve paid holidays throughout the calendar year.
• Eligibility for incentive and stock options.