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Executive, Portfolio Access and Reimbursement Manager (Mid-Atlantic)

External
eisai logoEisai · Maryland, Baltimore
Full-timeOn-site3d ago
HIPAALeadership
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At Eisai, satisfying unmet medical needs and increasing the benefits healthcare provides to patients, their families, and caregivers is Eisai's human health care (hhc) mission. We're a growing pharmaceutical company that is breaking through in neurology and oncology, with a strong emphasis on research and development. Our history includes the development of many innovative medicines, notably the discovery of the world's most widely-used treatment for Alzheimer's disease. As we continue to expand, we are seeking highly-motivated individuals who want to work in a fast-paced environment and make a difference. If this is your profile, we want to hear from you. The Executive Portfolio Access and Reimbursement Manager (PARM) will provide support for patient access to prescribed Eisai products through communication and education with healthcare professionals and internal Eisai staff. The Portfolio Access and Reimbursement Manager (PARM) serves as primary point of contact for all Oncology Access and Reimbursement education and patient support in an assigned geography. In addition, this role is the recognized subject matter expert and second level of support for complex access and reimbursement cases for both Oncology and Neurology. The PARM brings deep expertise in evaluating intricate payer issues, and will be engaged when a higher level of strategic or technical insight is required to address access challenges. In the event of an access or reimbursement issue that cannot be resolved by the local Access and Reimbursement Manager, the PARM will use Eisai-approved resources to diagnose the root cause of the access challenge and appropriately engage internal Eisai Market Access stakeholders or external stakeholders to provide access options to care. The PARM must have a strong understanding of PHI, state privacy laws, and compliant engagement standards as outlined by Eisai. Additionally, this role will have a keen understanding of payer coverage at the customer and regional level and strong communication skills to appropriately educate on payer policies. The PARM will support the Oncology and Neurology business units, providing access and reimbursement education. The PARM will serve as the lead field trainer for ARMs in their region and mentor new hires to the Access and Reimbursement team. The PARM must possess knowledge of buy-and-bill, J-code billing, and specialty distribution, and must also possess a deep understanding of the complexities of the evolving healthcare landscape, including the Inflation Reduction Act, Medicare Part D redesign, copay maximizers and accumulators, alternate funding programs, and other market access dynamics. The PARM role will be a field-based individual contributor reporting into the Eisai Access and Reimbursement team under Patient Services/Market Access. Working closely with, and reporting to, the Associate Director of Access & Reimbursement, the PARM will be responsible for providing education on access and reimbursement activities across HCP offices, alternate sites of infusion care, Medically Integrated Specialty Pharmacies, and health systems/institutions in both oncology and neurology. PARMs will interface with the following stakeholders, including, but not limited to: Health Care Professional, Practice Managers, Financial Counselors, Pharmacy Managers/Directors, Business Administrators, State Societies, C- and D-suite Health System personnel, and Revenue Cycle/Integrity professionals. Job Description Essential Functions Consistently demonstrate uncompromised integrity while working cross-functionally and collaboratively with Eisai internal and external stakeholders. Strong understanding of legal and regulatory parameters related to HIPAA guidelines, state privacy laws, patient access and support program services. Comply with all Eisai promotional and administrative policies and applicable law. Communicate with providers to understand challenges in the patient access process and provide appropriate information to help support patient access to prescribed Eisai therapy. Serves as the second level point of contact for the Access and Reimbursement Mangers for case escalations when payer delays, denials, or unclear information are relayed back to the healthcare provider, and there are no recognizable next steps for resolution. Engage with appropriate neurology and oncology accounts, providing them with access and reimbursement insight and/or education consistent with Eisai's policies. Appropriately educate on Eisai patient support programs consistent with Eisai policies. This would include answering questions about Eisai Patient Support programs and distribution channels to procure Eisai product(s). Serve as the ARM Field Training Lead, periodically working with Access and Reimbursement Managers to communicate field insights to Access and Reimbursement leadership and senior leadership. Appropriately communicate with cross functional colleagues & departments to compliantly


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