Access and Reimbursement Manager

Company: Disability Solutions
Location: Los Angeles
Posted on: April 3, 2025

Job Description:

Site Name: USA - California - Los AngelesPosted Date: Apr 1 2025Location: Los Angeles and Orange CountySpecialty Access & Reimbursement Manager (ARM) 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.
• Qualified candidates must possess a demonstrated track record of success working in a matrix environment and must demonstrate effective leadership skills. 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 a Director of Specialty Field Reimbursement. Basic qualifications:
    • Bachelor's Degree
    • Ability to travel up to 60% including overnights
    • Must live in or within 10 miles of the territory
    • Valid driver's license
    • 3+ 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 ProgramsPreferred 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.Why GSK?Our values and expectations are at the heart of everything we do and form an important part of our culture.These include Patient focus, Transparency, Respect, Integrity along with Courage, Accountability, Development, and Teamwork. As GSK focuses on our values and expectations and a culture of innovation, performance, and trust, the successful candidate will demonstrate the following capabilities:
        • Agile and distributed decision-making - using evidence and applying judgement to balance pace, rigour and risk
        • Managing individual and team performance.
        • Committed to delivering high quality results, overcoming challenges, focusing on what matters, execution.
        • Implementing change initiatives and leading change.
        • Sustaining energy and well-being, building resilience in teams.
        • Continuously looking for opportunities to learn, build skills and share learning both internally and externally.
        • Developing people and building a talent pipeline.
        • Translating strategy into action - a compelling narrative, motivating others, setting objectives and delegation.
        • Building strong relationships and collaboration, managing trusted stakeholder relationships internally and externally.
        • Budgeting and forecasting, commercial and financial acumen.The annual base salary for new hires in this position ranges from $142,500 to $237,500 taking into account a number of factors including work location within the US market, the candidate's skills, experience, education level and the market rate for the role. In addition, this position offers an annual bonus and eligibility to participate in our share based long term incentive program which is dependent on the level of the role. Available benefits include health care and other insurance benefits (for employee and family), retirement benefits, paid holidays, vacation, and paid caregiver/parental and medical leave.Please visit GSK US Benefits Summary to learn more about the comprehensive benefits program GSK offers US employees. Why GSK? Uniting science, technology and talent to get ahead of disease together. GSK is a global biopharma company with a special purpose - to unite science, technology and talent to get ahead of disease together - so we can positively impact the health of billions of people and deliver stronger, more sustainable shareholder returns - as an organisation where people can thrive. We prevent and treat disease with vaccines, specialty and general medicines. We focus on the science of the immune system and the use of new platform and data technologies, investing in four core therapeutic areas (infectious diseases, HIV, respiratory/ immunology and oncology).Our success absolutely depends on our people. While getting ahead of disease together is about our ambition for patients and shareholders, it's also about making GSK a place where people can thrive. We want GSK to be a place where people feel inspired, encouraged and challenged to be the best they can be. A place where they can be themselves - feeling welcome, valued, and included. Where they can keep growing and look after their wellbeing. So, if you share our ambition, join us at this exciting moment in our journey to get Ahead Together.If you require an accommodation or other assistance to apply for a job at GSK, please contact the GSK Service Centre at 1-877-694-7547 (US Toll Free) or +1 801 567 5155 (outside US).GSK is an Equal Opportunity Employer and, in the US, we adhere to Affirmative Action principles. This ensures that all qualified applicants will receive equal consideration for employment without regard to race, color, national origin, religion, sex, pregnancy, marital status, sexual orientation, gender identity/expression, age, disability, genetic information, military service, covered/protected veteran status or any other federal, state or local protected class.Important notice to Employment businesses/ AgenciesGSK does not accept referrals from employment businesses and/or employment agencies in respect of the vacancies posted on this site. All employment businesses/agencies are required to contact GSK's commercial and general procurement/human resources department to obtain prior written authorization before referring any candidates to GSK. The obtaining of prior written authorization is a condition precedent to any agreement (verbal or written) between the employment business/ agency and GSK. In the absence of such written authorization being obtained any actions undertaken by the employment business/agency shall be deemed to have been performed without the consent or contractual agreement of GSK. GSK shall therefore not be liable for any fees arising from such actions or any fees arising from any referrals by employment businesses/agencies in respect of the vacancies posted on this site.Please note that if you are a US Licensed Healthcare Professional or Healthcare Professional as defined by the laws of the state issuing your license, GSK may be required to capture and report expenses GSK incurs, on your behalf, in the event you are afforded an interview for employment. This capture of applicable transfers of value is necessary to ensure GSK's compliance to all federal and state US Transparency requirements. For more information, please visit the Centers for Medicare and Medicaid Services (CMS) website at https://openpaymentsdata.cms.gov/

Keywords: Disability Solutions, Los Angeles , Access and Reimbursement Manager, Executive , Los Angeles, California