Manager, Access & Reimbursement, Specialty

Individuals successful in this role possess a strong passion for patient access and thrive in a highly complex environment. The ability to problem solve and collaborate effectively is a critical skill set for GSK ARMs. This role requires exemplary customer engagement skills, a penchant for business ownership and the ability to understand nuanced reimbursement and access technical skills.

The responsibilities of the role include but are not limited to the following.

• Supports access to GSK Specialty products for appropriate patients.
• Specialty ARMs are responsible for educating providers on payer coverage, coding and payment policies related to GSK specialty products and helping providers understand GSK Patient Support Programs intended to help appropriate patients access GSK specialty medicines.
• Specialty ARMs routinely interface internally with Payer Account Managers, Specialty Pharmacy Account Directors and Specialty Sales professional teams.
• Analyze access/reimbursement issues and opportunities.
• Provide offices product access/reimbursement expertise.
• Provide access/reimbursement education to field teams.
• Coordinate on access/reimbursement issues with third parties including hubs.
• Support patient access to the products by providing subject matter expertise on reimbursement issues that may be barriers to product access.
• This role reports to Director of Specialty Access & Reimbursement.

Basic Qualifications:

• Bachelor's Degree
• 3+ years' experience in one or more of the following areas: Field Reimbursement, Payer Marketing, Specialty or Biologics Field Sales (HCP administered or Specialty Pharmacy provided).
• Ability to travel up to 60% including overnights
• Must live in or within 10 miles of the territory
• Valid driver's license

Preferred qualifications:

• MBA, MPH or other advanced degree
• In larger geographies the candidate should live within 50 miles of a major metropolitan airport.
• 6+ years' experience one or more of the areas including Field Reimbursement or Specialty or Biologics Field Sales (HCP administered or Specialty Pharmacy provided) or Payer Marketing or Patient Support Programs
• Reimbursement experience for immunology, respiratory, or other specialty injected/infused products in a buy and bill setting across all sites of care.
• Knowledge of the payer environment including state, federal, and private third-party; payer reimbursement methodologies; and payer policies for HCP and self-administered drugs.
• Demonstrated experience in customer focus with building relationships, issue identification and resolution, problem-solving and project management skills.
• Evidence of the ability to operate independently and handle multiple projects with a high degree of initiative. Ability to operate successfully as a leader in a matrix environment without direct reports.
• Organized, strategic thinker with excellent verbal, written and presentation communication skills.
• Knowledge of provider office and hospital outpatient department reimbursement environments, regulations, customers, and account-based planning.
• Knowledge of Specialty Pharmacy access process.
• Comprehensive understanding of Commercial, Medicare Parts A, B, C, D and state Medicaid reimbursement dynamics.
• Understanding of HCPCS, CPT, and ICD-10 coding regulations.
• Experience working with HUB or reimbursement call centers in support of patient access.

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Please visit GSK US Benefits Summary to learn more about the comprehensive benefits program GSK offers US employees.

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