Field Access Manager - Specialty Networks

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As a valued member of the Market Access Team, the Field Access Manager - Specialty Networks (FAM), Specialty Networks, plays a crucial role in ensuring access and reimbursement for the Telix brand portfolio across national accounts. Reporting to the National Field Manager, Market Access, the FRM embodies a 'patient-first' mindset and drives pull-through efforts to maximize patient access to Telix products. This role focuses on Site of Care engagement within specialty networks nationwide, providing reimbursement and access support, billing and coding education, and collaboration with Key Opinion Leaders (KOLs) to develop reimbursement strategies and review policy implications. The FRM will support major key accounts and specialty networks across the country, offering expertise in market access and reimbursement throughout the Telix product lifecycle, including pre- and post-launch initiatives. This role requires close coordination with internal teams and may involve travel to support national initiatives.

Key Accountabilities:

• 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
• 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

Education and Experience:

• 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
• Diagnostic Radiology and Oncology Experience strongly preferred
• 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 various payer policies and payment methodology for commercial and government insurance plans
• 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

Key Capabilities:

• Inclusive mindset: Demonstrate an understanding and appreciation for diversity, and actively work to create an inclusive environment where everyone feels valued and respected
• Creativity and innovation: Possess a willingness to think outside the box and come up with unique and creative solutions to challenges
• Commitment to excellence: Take pride in your work and consistently strive for excellence in everything you do
• Results-oriented: Driven to achieve goals and objectives, with a strong focus on delivering measurable results
• Ethical behavior: Act with integrity and demonstrate a commitment to ethical behavior in all interactions with colleagues and stakeholders
• Adaptability: Comfortable working in a dynamic environment, able to adjust to changing priorities, and willing to take on new challenges
• Strong communication skills: Able to communicate effectively with colleagues and stakeholders at all levels, using clear and concise language
• Collaboration: Work effectively as part of a team, actively sharing knowledge and expertise to achieve common goals
• Resilience: Demonstrate the ability to bounce back from setbacks and persevere in the face of challenges
• Continuous learning: Show a commitment to ongoing learning and professional development, continually seeking out opportunities to expand your knowledge and skills