Reimbursement Navigator

About the Role

The Redemplo Reimbursement Navigator (RRN) is responsible for managing assigned healthcare provider accounts and patient cases, within a defined geographic region, to advance patient access and reimbursement for Redemplo®. The RRN serves as a strategic reimbursement resource to healthcare providers, office staff, and internal stakeholders by delivering approved reimbursement education, facilitating patient access, resolving complex coverage and reimbursement challenges, and supporting patient case pull-through. The RRN collaborates cross-functionally with Sales, Market Access, Specialty Pharmacy, HUB partners, and other approved stakeholders to execute territory strategies while ensuring compliance with all company policies, privacy requirements, and applicable regulations.

Responsibilities

• Advance patient access and reimbursement through approved education, reimbursement support, and pull-through activities.
• Educate healthcare providers, office staff, and approved matrix partners on reimbursement processes, coverage pathways, financial assistance programs, and approved patient support services.
• Analyze complex reimbursement and access issues and develop appropriate strategies to facilitate patient access within approved policies and compliance guidelines.
• Coordinate with the HUB, specialty pharmacy, and approved partners to support patient enrollment, benefits investigations, prior authorizations, appeals, denied claims, and reimbursement-related case management.
• Serve as the local reimbursement and access expert for Sales, Market Access, and regional leadership.
• Develop and execute strategic territory plans in partnership with internal and external stakeholders to optimize patient access and customer support.
• Build and maintain collaborative relationships with healthcare providers, office staff, specialty pharmacies, patient support partners, and internal cross-functional teams.
• Proactively identify reimbursement barriers and implement compliant solutions that improve patient access and customer experience.
• Document customer interactions and maintain accurate records within approved company systems.
• Operate in full compliance with all company policies, legal, regulatory, privacy, and compliance requirements.
• Manage business travel and expenses within established company guidelines.

Requirements

• Bachelor's degree required; healthcare, life sciences, nursing, or a related field preferred.
• Minimum of seven (7) years of pharmaceutical and/or biotechnology industry experience.
• Minimum of three (3) years of experience in one or more of the following: Field reimbursement; Patient access and reimbursement; Specialty medication access solutions; Specialty pharmacy; Advanced specialty pharmaceutical sales; Patient support services.
• Demonstrated knowledge of pharmacy benefit reimbursement.
• Demonstrated ability to analyze and resolve complex reimbursement and patient access challenges.
• Strong understanding of specialty pharmacy operations and patient support services.
• Must reside within the assigned territory or territory boundaries.
• Valid driver's license with the ability to travel extensively throughout the assigned territory.

Preferred

• Experience supporting rare disease, cardiometabolic, or specialty pharmaceutical products.
• Experience supporting a commercial pharmaceutical product launch.
• Strong knowledge of payer coverage, reimbursement, specialty pharmacy, and patient support programs.
• Excellent presentation, communication, and relationship-building skills.
• Demonstrated strategic account planning, case management, and territory management capabilities.
• Ability to effectively collaborate across cross-functional teams.
• Strong analytical, problem-solving, and organizational skills.
• High emotional intelligence with the ability to build trusted relationships with customers and internal partners.
• Demonstrated accountability, ownership, adaptability, and customer focus.
• Ability to thrive in a dynamic, fast-paced environment while maintaining a high level of professionalism and compliance.

Pay

California pay range: $160,000 USD - $170,000 USD