Field Access Manager

Summary

Join Telix Pharmaceuticals as a Field Access Manager and contribute to the international rollout of its prostate cancer imaging agent. This hybrid role involves managing regional payer accounts, developing and executing strategies for policy creation and implementation, and acting as a reimbursement and payer policy subject matter expert. You will work directly with site of service support staff, providers, and other stakeholders to ensure patient access to Telix products. The position requires strong communication, collaboration, and influencing skills, along with a deep understanding of healthcare policies, regulations, and reimbursement frameworks. You will also be responsible for educating site of service staff on medical policy and building relationships with key opinion leaders. This role offers the opportunity to shape healthcare policies and reimbursement practices and make a significant impact on patient care.

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 on various payer policies and payment methodology for commercial and government insurance plans
• Experience working with regional, national or government payer entities surrounding policy development and implementation
• 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
• Manage Regional Payer Accounts from pre-commercial through launch and maintenance within an assigned geography
• Engage with policymakers, industry associations, and advocacy groups to shape healthcare policies and reimbursement practices locally and regionally
• Deliver Market Access Value Proposition to Population Health Decision makers, Medical Directors, Policy Development Directors, Drug Utilization Review Committees, and Formulary Managers where appropriate
• Develop and execute strategy for policy creation and implementation with assigned regional payers, and remain accountable for the medical policy outcomes, favorable placement, and removal of barriers to access within regional payer medical policies
• 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