Operational Manager, Reimbursement (Patient Support Services)

AbbVie's mission is to discover and deliver innovative medicines and solutions that solve serious health issues today and address the medical challenges of tomorrow. We strive to have a remarkable impact on people's lives across several key therapeutic areas – immunology, oncology, neuroscience, and eye care – and products and services in our Allergan Aesthetics portfolio. For more information about AbbVie, please visit us at www.abbvie.com. Follow @abbvie on X, Facebook, Instagram, YouTube, LinkedIn and Tik Tok.

The Manager for Oncology Access and Reimbursement Services will implement the development,

implementation and on-going management of the Oncology Access and Reimbursement Services team.

The Access and Reimbursement Services team will be responsible for serving as a dedicated point of

contact, fully integrated with the AbbVie Oncology Access & Reimbursement Service model, for

healthcare providers and patients for their access and reimbursement support needs. The Team will

help patients and healthcare providers navigate through patient support and reimbursement issues.

The Manager will ensure compliance with federal, state and AbbVie requirements. The Manager must

be able to collaborate cross -functionally and promote a culture of patient centricity and a high standard

of support excellence within the team and Pharmacy Solutions and meeting agreed upon goals and

objectives.

Responsibilities:

•The Manager for Oncology Access and Reimbursement Services will implement the development,

implementation and on-going management of the Oncology Access and Reimbursement Services

team delivering both centralized and field based capabilities.

•The Oncology Access and Reimbursement Service model is responsible for serving as a

reimbursement navigator for patients, healthcare providers and pharmacies that opt into Access and

Reimbursement Services for both oral and IV AbbVie Oncology products.

•Access and Reimbursement Case Coordinator team will independently manage a case load within

his/her assigned area and provide seamless coverage for other Access and Reimbursement Case

Coordinators case load when necessary.

•Successfully manage critical conversations with patients, healthcare providers and pharmacies.

•Perform comprehensive assessment of each case to determine appropriate avenue to maximize

patient access to AbbVie Oncology products.

•Serve as the Pharmacy Solutions point of contact overseeing the contracted Oncology Access and

Reimbursement Field Reimbursement program in close collaboration with their cross functional

counterparts, including representing Pharmacy Solutions in vendor contracting negotiations,

collaborating on KPI development and monitoring, development and execution of seamless operating

model between the ARCC and FRM roles and compliance monitoring.

•Partner with external Field Reimbursement team to identify additional resources and share current

payer and reimbursement trends. Respond to reimbursement questions and identify alternative

resources available.

•Provide guidance through Open Enrollment, including Medicare Part D. Determine eligibility for

AbbVie free goods program. Provide support to customers in the implementation of AbbVie REMs

programs (if applicable).

•Develop and maintain a localized understanding of market access challenges. Utilize expertise to

educate patients, healthcare providers and internal cross-functional partners.

•Develop and execute AbbVie Access and Reimbursement Services business plan for accounts in

assigned area. Establish goals and develop support plan.

•Bachelor’s degree in health sciences or business preferred. MBA qualification is desirable. Comparable or relevant experience will be considered.

•3-5 years’ experience leading reimbursement support teams in a hospital facility or large scale medical office specializing in oncology is highly desirable.

• C1 English Level

•Demonstrate thorough knowledge of reimbursement and access best practices across multiple Patient Access Support options (hospital charity programs, manufacturer patient assistance programs, co-pay card programs, etc.)

•Strong problem solving skills related to complex patient access challenges.

•Experience working with providers to resolve or prevent account issues related to proper coding, billing, denials, and claims appeals related to product coverage and reimbursement.

•Experience educating and mentoring peers and direct reports.

•Experience educating office and hospital staff in reimbursement processes including payer requirements for Prior Authorization, Pre-Determination, Appeals, and Claims submission guidelines.

•Knowledge of Commercial and Medicare reimbursement guidelines and insurance plan reimbursement methodology

AbbVie is an equal opportunity employer and is committed to operating with integrity, driving innovation, transforming lives and serving our community.  Equal Opportunity Employer/Veterans/Disabled. 

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