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Sage Therapeutics is currently recruiting for an Associate Director, Access Reimbursement Management to join their National Access Reimbursement Manager (ARM) team within the Market Access field organization. The Associate Director, Access Reimbursement Management will provide education, assistance, and issue resolution with healthcare providers (HCPs) and their office staff for patient access to Sage in-line products. Outreach may be telephonic as well as in-person. Stakeholders include HCPs and office staff that are writing prescriptions for in-line Sage products, other healthcare settings utilizing Sage products, Sage Sales colleagues Patient Support Navigators, National Account Directors, Regional Account Directors, Specialty Pharmacies, and Payers (Health Plans and PBMs). In this role, you will be responsible for:
Roles And Responsibilities (Essential Functions)
Equipping HCPs and their staff, through education, to navigate the patient-level payer access requirements and approval process within a specified geographic region.
Demonstrate an advanced understanding of public and private payers and how to research to determine specific coverage barriers and communicate effectively to internal stakeholders and external HCPs regarding education on Medicaid and Medicare (FFS and Managed Care), commercial plans, PBM designs, policy changes, and formulary status.
Comprehensive knowledge of pharmacy benefit reimbursement practices, compliance, billing and coding processes, and utilization management / prior authorization process.
Compliance with all Sage corporate policies, internal procedures and training, and applicable laws and industry codes in collaboration with Sage’s Legal, Regulatory, and Compliance
Reference billing and coding materials provided to healthcare settings to educate sites on coding specific to the drug and administration as requested by healthcare settings.
Confidently reference reimbursement and access materials to educate HCPs on access related questions.
Implementing and supporting the strategic tactical plan for the execution of product access and reimbursement through partnership with internal and external stakeholders.
Full understanding of key stakeholders within an HCP office and how to navigate relationships independently and confidently in a manner that anticipates and adapts to customer reimbursement support needs and any market access challenges.
Utilize advanced reimbursement skills to work cross functionally with other areas of Sage on key projects and initiatives.
Assist in providing field insights for the development of Market Access support materials.
Serve as escalation point for patient support navigators when complex patient-level access challenges arise.
Experience, Education And Specialized Knowledge And Skills
Must thrive working in a fast-paced, innovative environment while remaining flexible, proactive, resourceful, and efficient. Excellent interpersonal skills, ability to develop important relationships with key stakeholders, good conflict management and negotiation skills, and ability to analyze complex issues. Demonstrated ability to analyze complex situations and communicate a path forward in a simple, streamlined manner.
Basic Qualifications
Bachelor’s degree required.
Minimum of 6 years experience in payer marketing, patient support programs, or field reimbursement support.
Preferred Qualifications
Minimum 3 years experience in pharmaceutical and/or health care industry or experience in a direct customer facing role (i.e., field sales, account management, etc.)
Advanced understanding of the healthcare environment specifically around delivering services to Health Care Professionals and Patient customers.
Understanding of specialty pharmacies, managed care, medical and pharmacy benefit, and government payers and their impact on product access.
Ability to manage multiple internal touch points and effectively prioritize the support of field service requests within a large geographical region.
Experience navigating through complex access challenges specific to specialty pharmacy in multiple regions / states.
Ability to communicate payer coverage criteria, payer policy, and prior approval processes.
Understanding of national and state legislative, Medicare, Medicaid, and private payer and pharmacy coverage initiatives affecting reimbursement of pharmaceutical and biotechnology products.
Results oriented, self-organized and self-starter with a proven track record of results.
Possess strong critical thinking, problem solving, and analytical skills with high attention to detail.
Possesses strong written and verbal communication skills.
Desire to innovate and work in a fast-paced, energetic environment with competing priorities.
Ability to Travel up to 30% for key meetings and customer relationships.
Must be located within 50 miles of a major airport in or near the territory
Valid driver’s license
Specialty pharmacy reimbursement experience
Embrace our core values: Put People First, Improve Lives, Cultivate Curiosity, Do Right, and Forge New Pathways.
Excitement about the vision and mission of Sage.
Benefits and Compensation The base salary hiring range for this position is $161,180 - $221,623.*
The actual salary offered within the range is dependent on a variety of factors including, but not limited to, relevant experience, qualifications, education, skills, and performance.
This position is eligible to participate in the Company’s annual bonus plan; the bonus varies based on performance and is subject to the standard terms and conditions of the incentive program.
To support your well-being, we offer a comprehensive benefits and wellness package, which includes medical, dental, and vision coverage upon hire. More information can be found in our Benefits Guide .
*Base salary ranges are periodically reviewed and subject to change.
Seniority level
Director
Employment type
Full-time
Job function
Project Management and Marketing
Industries
Pharmaceutical Manufacturing and Biotechnology Research
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