Shire Field Reimbursement Manager - South LA, Orange County in Remote, California

The Ophthalmics Field Reimbursement Manager (FRM) helps to minimize reimbursement barriers for patients and providers and, therefore, helps to optimize access to OBU products in an assigned geography. The FRM works closely with internal partners in educating accounts regarding the reimbursement and access landscape and problem solving patient access challenges. They also execute ethical and solutions-oriented reimbursement programs and tactics, and proactively communicate payer information, including status, processes and practices.

  • Works with internal partners to execute franchise, managed care, and territory business plans and objectives

  • Develops long-term & short-term strategic account plans focusing on patient access to OBU therapies

  • Develops and shares local market insights with colleagues to better understand barriers impacting access to OBU therapies

  • Acts as a subject matter expert on the payer landscape relevant to the OBU Problem solves with respect to patient access challenges

  • Key account partnerships which includes educating on OBU therapies payer coverage, prior authorization requirements, and medical necessity requirements

  • Executes ethical and solutions-oriented reimbursement programs and tactics

  • Trouble-shoots field account reimbursement issues, needs, concerns, or challenges

  • Partners with third party OBU vendors Leverages available resources, including market access and demographic data to develop and execute account plans/call purpose.

  • Proactively communicates and explains OBU/Shire-specific reimbursement programs, policies, procedures and resources

  • Works with relevant state, institutional or other societies regarding reimbursement topics

  • Complies with all laws, regulations and policies that govern the conduct of Shire activities

  • Business travel, by air or car, is regularly required

Responsibilities

  • Meet and exceed the FRM team objectives

  • Meet and exceed the OBU objectives

  • Strong collaboration and communication with local market unit (Zone Director, Region Director, Sales Representatives, Key Account Managers, Market Access partners) to develop action plans to prioritize business and reimbursement needs, identify key FRM accounts, and to establish and maintain the team communication plan and pathway

  • Proactively seek and reactively respond to identified coverage, access and reimbursement issues and challenges

Education and Experience Requirements

  • Minimum 2 years practice-facing, field-based reimbursement experience in the medical/pharmaceutical industry

  • Strong knowledge and understanding of managed care: commercial payers, Medicare (including Part D and Low Income Subsidy), Medicaid and Specialty Pharmacy

  • Must demonstrate excellent working knowledge of access and reimbursement, as well as the practice management environment

  • Demonstrated ability and capacity to successfully negotiate and manage competing priorities

  • Bachelor’s degree (B. A.) from four-year college or university, or degree-equivalent experience

  • Eye care/Ophthalmology experience strongly preferred

  • Strategic agility – Links responsibilities with the mission of the organization.

  • Business Acumen (strategic thinking/planning, analyzing/diagnosing, external perspective, accelerating change)

  • Supporting Regulatory Environment

  • Demonstrated leadership skills and ability to lead without authority with internal and external

  • stakeholders

  • Communicating with Impact (influencing, listening and receptivity, candid and direct communication)

  • Working Effectively with Others (builds rapport, collaboration and teamwork, org savvy, energizing and engaging

  • Navigates the complex regional payer landscape for OBU therapies; identify issues and facilitate problem-solving process

  • Provides information on access requirement and processes, coverage and policy updates and patient resources to external customers

  • Moderate travel required.

  • Must work evenings and weekends as needed.

  • Work is from home. No office is provided by company.

  • South Los Angeles, Orange County

Notice to Employment / Recruitment Agents:

Employment / Recruitment agents may only submit candidates for vacancies only if they have written authorization to do so from Shire’s Talent Acquisition department. Any agency candidate submission may only be submitted to positions opened to the agency through the specific Agency Portal. Shire will only pay a fee for candidates submitted or presented where there is a fully executed contract in place between the Employment / Recruitment agents and Shire and only if the candidate is submitted via the Agency Portal. Candidates submitted or presented by Employment / Recruitment Agents without a fully executed contract or submitted through this site shall not be deemed to form part of any Engagement for which the Agency may claim remuneration.

Equal Employment Opportunity

Shire is an Equal Opportunity Employer committed to a diverse workforce. Shire will not discriminate against any worker or job applicant on the basis of race, color, religion, gender, national origin, ancestry, age, sexual orientation, marital or civil partnership status, pregnancy, gender reassignment, non-job related mental or physical disability, genetic information, veteran status, military service, application for military service, or membership in any other category protected under law.

EEO is the Law - https://www.dol.gov/ofccp/regs/compliance/posters/pdf/eeopost.pdf

EEO is the Law – Supplement - https://www.dol.gov/ofccp/regs/compliance/posters/pdf/OFCCPEEOSupplementFinalJRFQA508c.pdf

Pay Transparency Policy - https://www.dol.gov/ofccp/pdf/pay-transp_formattedESQA508c.pdf

Reasonable Accommodations

Shire is committed to working with and providing reasonable accommodation to individuals with disabilities. If, because of a medical condition or disability, you need a reasonable accommodation for any part of the application process, or in order to perform the essential functions of a position, please call 484-595-8400 and let us know the nature of your request and your contact information.

Shire is the leading global biotechnology company focused on serving people with rare diseases and other highly specialized conditions. We strive to develop best-in-class products, many of which are available in more than 100 countries, across core therapeutic areas including Hematology, Immunology, Neuroscience, Ophthalmics, Lysosomal Storage Disorders, Gastrointestinal/Internal Medicine/Endocrine and Hereditary Angioedema; and a growing franchise in Oncology.

Our employees come to work every day with a shared mission: to develop and deliver breakthrough therapies for the hundreds of millions of people in the world affected by rare diseases and other high-need conditions, and who lack effective therapies to live their lives to the fullest.