Field Reimbursement Manager

About the role

This position is a critical front-line member of the Keenova Access and Reimbursement team. The Field Reimbursement Manager (FRM) represents Keenova's interest with Xiaflex, Testopel, Aveed, and Supprelin LA with HCP accounts, as well as all internal Keenova stakeholders and field sales personnel. The FRM will be an expert and provide education, training, and hands-on assistance related to access of the above products.

Responsibilities

• Manage patient assistance and reimbursement support services offered to providers and related to patient access to buy/bill products.
• Coordinate with Keenova’s patient support services program representatives.
• Educate office staff on the use of Buy/Bill products patient assistance and reimbursement support services.
• Participate in sales training related to product reimbursement.
• Utilize data to critically think through acquisition challenges from a variety of outlets including Specialty Pharmacies, Specialty Distributors, and Title sales.
• Aid new offices from a reimbursement perspective to inform them about reimbursement issues as well as education on various MARC approved resources pertaining to reimbursement, acquisition, and coding.
• Work closely with Specialty Pharmacies to understand logistical issues that arise and provide MARC approved resources and programs to facilitate patient access as well as communicate with SP’s to find resolutions to issues that arise at the SP.
• Identify gaps in knowledge of accounts from a Specialty Pharmacy process and help provide education for the account and physician.
• Consistently, reliably, and timely support the field, as well as all other internal commercial functions.
• Partner with the DM’s to build local business plans; participate in district business reviews as the expert resource on the reimbursement landscape from regional, district, state, and local perspective.
• Provide the teams with actionable feedback (across the organization) on support programs such as the Helpline, copay card, SPP performance, so as to guide changes to improve access.
• Help educate the internal customers on managed market dynamics specific to SP’s/SD’s as well as local payor issues-needs.
• Track customer trends in order to help inform internal business decisions.
• (E.g. Health care policy changes…).
• Proactively use business analytics to understand common logistical issues in top accounts and proactively develop plans for education and to find solutions for better patient access to Xiaflex, AVEED, Testopel, and SLA.
• Ensure alignment with DM and District Strategy.
• Support sales representatives and District Managers/Internal Stakeholders on rules of engagement to educate and further clarify what is appropriate.
• Work with the field to identify potential payer advocates and supports the National Account Management team on issues relating to medical policy development and execution at the HCP level.
• Ensure all Keenova approved promotional speakers have an in-depth understanding of billing/coding, logistics, and payer coverage.

Qualifications

• Education & Experience: BS or equivalent, MBA or advanced degree ideal. 5-7 years of relevant experience. Previous experience working with vendor relationships desirable. Previous experience managing customer interactions. Previous sales management and/or account management experience highly desirable.
• Knowledge: Systemic understanding of the global payer and distribution environment, in particular, biologic In-Office Injectables (IOI) in the U.S. Understanding of coverage, coding (diagnostic, procedural and product), payment and reimbursement requirements and policies. Knowledge / expertise in Local Coverage Determinations (LCDs) per each regional MAC for all KEENOVA products. Knowledgeable on Medicare billing/coding and appeal process. ASP, WAC as well as Sequestration; interpret and understand Medicare EOBs and CMS 1500 forms. Understands the legislative, legal, and regulatory environments and anticipates potential impact to Keenova. Solid understanding of coverage policy creation, interpretation, and management.
• Skills & Abilities: Significant sales experience in the biologic (injectable) market. Ability to synthesize clinical literature and target product profile in order to understand implications for value to payers, patients, and health care providers and Keenova. Strong written and verbal communication skills, with an ability to condense complex information into concise outputs and direction. Ability to work with health care providers and insurers to explain and help manage all issues related to product access. Ability to balance external stakeholders’ wants with Keenova needs. Hands–on operational reimbursement experience – in-house and outsourced experience desirable. Demonstrated ability to work with multiple stakeholders in a collaborative and constructive manner. Establishes relationships with appropriate field personnel, accounts, payers, and vendors. Comfortable working in a transparent environment (fair balance, full disclosure, Safe Harbors, etc.).

Benefits

Keenova offers employees a Total Rewards package which includes competitive pay and benefits. To learn more about our Total Rewards benefits please visit: Keenova Careers | Serve and Grow with Purpose | Keenova

Pay

The position is eligible for a bonus in accordance with the terms of the applicable program. Bonuses are awarded at the Company’s discretion.

Schedule

Significant travel involved. The role is field based, ideally living in the Little Rock, AR area.