Field Reimbursement Manager Market Access - Central Region

ADMA Biologics is a biopharmaceutical company relentlessly committed to creating superior products for immunodeficient patients at risk for infection. It is our devotion to this underserved population that fuels us and our hands-on approach to production and development that sets us apart. If you are looking for a dynamic, innovative, growing company in the biopharmaceutical industry that is committed to excellence and integrity, then consider ADMA Biologics.

About the role

Position Summary The Market Access Field Reimbursement Manager (FRM) (Central Region) 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.

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.
• 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.
• Cover the Central region and be responsible for the central United States, as well as covering additional regions as needed.
• Perform remote work with travel within the region and national meetings approximately 65‑75% of the time.
• Support healthcare providers and ADMA field teams across the following regions: Great Lakes (Ohio, Michigan, Western Pennsylvania including Pittsburgh), Upper Midwest (Illinois, Wisconsin, Indiana), Great Plains (Kansas, Missouri, Nebraska, Iowa, Oklahoma, Minnesota, Arkansas).

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 (Commercial, Medicare, Medicaid, VA/DOD/Tricare, ACA) and a deep understanding of Medical and Pharmacy benefits, billing and coding practices for infused products.
• 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.
• Ability to understand and clearly disseminate payor policy and criteria for coverage in the medical and pharmacy benefit to existing and future providers.
• Ability to think independently, analyze issues and make recommendations that will help providers and patients obtain coverage to start therapy.
• 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.
• Responsible for ensuring compliance with all ADMA Quality policies, standards, and SOPs; ensuring QA records and reports, HR policies, and EH&S procedures are completed timely.
• Proficient in Microsoft Office, Excel, PowerPoint, and Teams.
• Strong people skills.
• Excellent written and verbal communication skills.

Qualifications

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

Benefits

• 401K plan with employer match and immediate vesting
• Medical, Vision, Life and Dental Insurance