Manager Access and Reimbursement Services

About the role

The Manager Access and Reimbursement Services leads the development, implementation and ongoing management of the Access and Reimbursement Services team. The team acts as a dedicated point of contact, fully integrated with the AbbVie Complete Access model, for healthcare providers and patients who need access and reimbursement support. The manager ensures compliance with federal, state and AbbVie requirements and promotes a patient-centred culture of support excellence.

Key responsibilities

• Build and run a centralized and field-based reimbursement support function, acting as a reimbursement navigator for patients, providers and pharmacies.
• Manage the Insurance Specialist team, covering its own cases and supporting other case coordinators when needed.
• Lead critical conversations with patients, providers and pharmacies and assess each case to maximise patient access to AbbVie products.
• Act as the AbbVie Complete Access subject matter expert, overseeing the contracted reimbursement program, vendor contracting negotiations, KPI development and monitoring, and the operating model between the Insurance Specialist and field reimbursement manager roles.
• Partner with the external field reimbursement team on payer and reimbursement trends, and guide customers through Open Enrollment, including Medicare Part D.
• Determine eligibility for the AbbVie free goods program and support customers in implementing AbbVie programs.
• Develop and execute the business plan for accounts in the assigned area, set goals and build a support plan.

Required profile

• Bachelor's degree with a background in health sciences or business preferred; MBA desirable.
• 3-5 years' experience leading reimbursement support teams.
• Proven track record of leading others and managing call center operations, including quality monitoring and performance management.
• B2+ English proficiency, able to communicate effectively in writing and verbally.

Required skills

• Knowledge of reimbursement and access best practices across hospital charity programs, manufacturer patient assistance programs and co-pay card programs.
• Experience resolving provider account issues around coding, billing, denials and claims appeals.
• Experience educating and mentoring peers and direct reports, and teaching reimbursement processes such as prior authorization, pre-determination, appeals and claims submission.
• Knowledge of commercial and Medicare reimbursement guidelines and insurance plan reimbursement methodology.