Access Reimbursement Manager Operations Lead

United States·Field-Basedlead

OtherOperations Lead

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Quick Summary

Requirements Summary

Bachelor’s degree required or equivalent work experience 5+ years of experience in one or more of the following areas: Managed Care, Field Reimbursement, Patient Services,

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OtherOperations Lead

Nice to Have

~2 min read

Driving team development (managing a large team >10 ARMs) and fostering a high-performing culture while ensuring accountability for achieving access-related objectives.
This individual will have deep expertise in managing the day-to-day Key Performance Indicators to ensure the team is tracking to aligned objectives with the Client. Own day-to-day performance monitoring of ARM KPIs, including activity, account engagement, access barrier trends, CRM utilization, educational pull-through, and other agreed-upon measures. Translate performance trends into actionable coaching, operational adjustments, and executive-ready business reviews.
Ability to understand and articulate complex data sets and provide summaries and quarterly reports and presentations that will be delivered to Executive Leadership.
Liaise with the Client’s Data and Analytics team & Market Access Lead to improve and refine ARM Key Performance Indicators, as needed.
Lead and manage all operational aspects to include ARM roster management, CRM management, dashboard reporting (support) and other access performance measures.
Coordinate initial ARM onboarding, sourcing and recruiting support, expense tracking/reporting, training logistics, and meeting coordination with the client and ARM Team. Coach, mentor, and empower ARMs to deliver exceptional educational support to healthcare providers and patients to help facilitate patient access. Provide strategic and operational oversight to ensure ARMs consistently deliver compliant education to provider offices on payer coverage, prior authorization requirements, benefit verification workflows, appeals/denials processes, affordability resources, specialty pharmacy coordination, and patient support program navigation.
Acted as a trusted advisor and partner to the Client.

Requirements

~2 min read

Bachelor’s degree required or equivalent work experience
5+ years of experience in one or more of the following areas: Managed Care, Field Reimbursement, Patient Services, and/or Sales (Specialty or Biologics), or Field Operations.
At least 3+ years in access management roles and/or 3+ years of direct people management experience or relevant experience. Solution oriented mindset, strong business acumen, & strong analytic capabilities.
Experience and understanding of Retail & Specialty Pharmacies.
Ability to do field rides, to monitor Compliance related activities, team meetings, client meetings, training sessions, and national/regional business reviews; estimated travel requirement should be defined based on client expectations.
Ensure all ARM activities are conducted in accordance with approved program parameters, client policies, legal/compliance guidance, privacy requirements, adverse event/product complaint reporting obligations, and all applicable federal and state requirements.
Understanding of Third-Party data sets (Symphony Health, Copay, etc.).
Ability to deliver presentations via technology platforms such as Zoom, Webex, and/or Teams.
Advanced knowledge of medical insurance terminology and payer policies.
Knowledge of Centers of Medicare & Medicaid Services (CMS) policies and processes with expertise in Medicare (Part D for Pharmacy Benefit products).
Track and monitor budget, expenses, contracts, and operational deliverables to ensure timely reporting and appropriate financial stewardship. Ability to manage ambiguity & problem solve.
Prepare and submit appropriate expense reports in a timely fashion.
Valid Driver’s License.