Field Access Manager

Summary

Join Telix Pharmaceuticals as a Field Access Manager - Specialty Networks and play a crucial role in ensuring access and reimbursement for Telix brand products. You will work directly with healthcare providers and staff, educating them on billing, coding, and reimbursement processes. This position requires developing relationships with Key Opinion Leaders (KOLs) to support patient advocacy and developing reimbursement strategies. You will also monitor healthcare policies and regulations, providing updates to stakeholders. The role involves close coordination with internal teams and may require travel. Telix offers competitive salaries, bonuses, an equity-based incentive program, generous vacation, paid wellness days, and support for learning and development.

Requirements

• BA/BS Degree or equivalent work experience required
• 5+ years' experience in the pharmaceutical or biotech industry, preference to Market Access Roles
• 3+ years of experience in healthcare coverage, coding and/or reimbursement
• Direct experience with buy and bill products, Medicare Part B and miscellaneous codes
• Previous experience working with billing, coding and medical claims
• Understand the various nuances of the different claims settings or sites of care; physician office, hospital outpatient, IDTF
• Well versed in implementing and educating various payer policies and payment methodology for commercial and government insurance plans
• Understanding of oncology buy and bill model with commercial and government-based payers; recent experience preferred
• Knowledge and understanding of specialty markets, HUB/Reimbursement support and patient access programs
• Strong influence and collaboration skills for external and internal stakeholders
• Ability to travel 20-40% depending on the needs of the region and customers

Responsibilities

• Work directly with site of service support staff, providers, and other important stakeholders involved with patient access for all things reimbursement, including but not limited to, education around billing and coding, appeal or denials, patient support services, and appropriate use criteria for the Telix brand portfolio
• Educate site of service staff on medical policy and web-based educational links to provide information on relevant reimbursement topics or policy criteria
• Develop KOL relationships to support patient advocacy, and leverage relationships for grassroots efforts when needed
• Be the reimbursement and payer policy subject matter expert as it relates to Telix brand portfolio and competitor landscape, and understand all applicable reimbursement regulations for Medicaid, Medicare and Commercial payers
• Establish and maintain knowledge of the local and national payer landscape, and be able to clearly communicate challenges and opportunities to internal and external stakeholders
• Perform Access Reviews within Key accounts to determine if the account is receiving reasonable and customary reimbursements for services provided
• Monitor and analyze healthcare policies, regulations, and reimbursement frameworks that impact market access and reimbursement, and provide updates to site of service accounts, internal and external stakeholders
• Organize and complete administrative responsibilities in a timely manner, including but not limited to, case reporting, success and challenges reporting, expense reporting, vacation, and time-off reporting

Preferred Qualifications

Diagnostic Radiology and Oncology Experience strongly preferred

Benefits

• Competitive salaries
• Annual performance-based bonuses
• An equity-based incentive program
• Generous vacation
• Paid wellness days
• Support for learning and development