Key Responsibilities Act as a compliant SME in reimbursement, access, and specialty distribution for assigned geography. Educate HCP offices on coverage status, prior authorization, appeals, and alternate funding options for uninsured/underinsured patients. Build relationships with HCPs, office staff, and health system stakeholders. Analyze payer coverage trends, reimbursement criteria, and payer mix. Guide specialty pharmacy services and help customers navigate distribution channels. Partner with Patient Support for accurate benefit investigations and streamlined patient onboarding. Collaborate with internal partners to develop local access strategies. Develop and execute territory-level business plans using customer insights. Resolve reimbursement issues and elevate cases as needed; identify process improvements. Maintain compliance with legal/regulatory/company policies (including patient privacy and promotional conduct). Requirements Bachelor’s degree in an allied health field (preferred) or equivalent experience. 8+ years in pharmaceutical/biotech/healthcare. Required: substantial reimbursement experience with prior authorizations and the US payer landscape. 3–6 years supporting Specialty Pharmaceuticals/Biologics. Deep knowledge of reimbursement/access and specialty pharmacy operations. Experience with product launches or guiding patients through insurance approvals. Strong specialty pharmacy distribution and patient services program knowledge. Knowledge of HIPAA and federal/state patient confidentiality/communications laws. Bilingual (English/Spanish) highly desired. Exceptional communication/interpersonal skills; comfortable with ambiguity, multiple cases, and real-time problem solving. Digital fluency with CRM; comfort educating on technology-enabled (incl. AI) support tools. Benefits 401(k) with company match; medical/dental/vision. Life/AD&D; short/long-term disability. HSA/FSA; EAP; performance-based incentive compensation. Paid parental leave; mental health resources; additional insurance and professional development/discounts. #J-18808-Ljbffr
...is in need of great Bilingual (Spanish) Triage Nurse to join our team! We are a full service... ...instructed by provider/triage protocolsTake telephone messages and provide feedback and... ...Practical NurseTo learn more please visit us at Work RemotelyNo#J-18808-Ljbffr...
...About the Job COMMUNITY SUPPORT WORKER Conexio New Castle Conexio Community-Community Support Worker in New Castle DE Today, Conexio Care serves as one of Delaware's largest nonprofits, collaborating with government, community, corporate, and other philanthropic...
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