What You'll Do
- Guide healthcare teams through post-prescription access challenges, focusing on payer policies and coverage pathways for HIV therapies.
- Train office staff to independently manage reimbursement processes, with an emphasis on long-acting injectable treatments.
- Identify systemic barriers to treatment access and lead cross-functional efforts to resolve them.
- Develop action plans with clear next steps, assigned owners, and timelines to ensure timely resolution of access issues.
- Coordinate with internal teams to align strategies and execute unified solutions for key accounts.
- Respond to complex reimbursement inquiries, offering timely and accurate guidance to keep patients on therapy.
Requirements
- Bachelor’s degree required
- Minimum of five years in pharmaceutical reimbursement, specialty pharmacy support, payer marketing, or patient assistance programs
- Proven understanding of J and Q codes, along with billing protocols for specialty treatments
- Willingness and ability to travel frequently, exceeding 50% of the time
Preferred Qualifications
- Familiarity with Medicare Parts B, C, D, Medicaid, and commercial payer structures
- Experience supporting injected or infused specialty drugs in buy-and-bill environments
- Background working with reimbursement HUBs and specialty pharmacy networks
- Strong ability to explain complex reimbursement systems clearly and effectively
- Skilled in building relationships, solving problems independently, and driving process improvements
- Demonstrated success in educating clinical teams on access workflows
- Leadership experience, including peer collaboration and indirect influence
- Knowledge of key accounts and existing provider relationships in the region
Benefits
This role supports a mission-driven organization focused on ending HIV/AIDS. The environment is fast-paced, inclusive, and centered on patient impact, with a holistic approach to treatment and care. Work is location-specific, based in Orlando, FL, with regular regional travel expected.
