Sr Business Advisor, Reimbursement - Eye Care- Southwest Region


Allergan


Posted Under: Phoenix, Arizona jobs in Other; Other jobs in zipcode 85001
Posted On: 2019-10-11 00:00:00

The primary function of the ReimbursementBusiness Advisor (RBA) is to work with health care provider accounts and facilitiesto support patient access for Allergan Eye Care reimbursed products. The RBAdoes this through 1) product-specific provider reimbursement support, 2) coordinationof HUB reimbursement services, and 3) managing payer/coverage pull-throughinitiatives.?The RBA is responsible for managing an assignedterritory and providing Allergan product reimbursement assistance and approvedsupport tools and resources to health care providers in physician practices andsurgical facilities. The RBA helps health care providers and support staff workthrough reimbursement barriers and understand the payer landscape. The RBAprovides this help and support while focusing on streamlining the use ofspecific Allergan products with appropriate patients for FDA-approved andFDA-cleared indications. The RBA must have a solid working knowledge of buy-and-billand medical device reimbursement, as well as a clear understanding of Medicare,Medicare Advantage, Commercial, and Medicaid insurance plans and benefit design.?The RBA must work effectively with multiple keyAllergan stakeholders (sales, marketing, managed markets, compliance, legal, andregulatory) in a matrixed environment to achieve targeted MBOs and meetestablished KPIs. The RBA is expected to be a subject matter expert onreimbursement processes (i.e., benefit verification, prior authorization, claimassistance, and appeals) and knowledgeable of current eye care market dynamics.In addition, the RBA needs to build and maintain strong relationships withhealth care provider practices and facilities, while implementing and managingfield reimbursement responsibilities. The RBA role includes a great deal of travel,and requires a high degree of communication, account coordination andcross-functional collaboration.?TheRBA must conduct all work activities in compliance with all Allergan internalrequirements and meet all applicable business, compliance, legal, andregulatory requirements. Education ?????????Bachelor?sdegree, MBA desirable?????????Healthcare credentialing and/or certification desirable?Experience margin-bottom:0in;margin-left:.5in;margin-bottom:.0001pt;mso-add-space:auto;text-indent:-.25in;line-height:normal;mso-list:l0 level1 lfo2"> ?????????In-depthand current knowledge of today?s health care environment, specifically buy-and-billand medical device reimbursementmargin-bottom:0in;margin-left:.5in;margin-bottom:.0001pt;mso-add-space:auto;text-indent:-.25in;line-height:normal;mso-list:l0 level1 lfo2"> ?????????Minimumof 5?7 years of proven success in a health care related fieldmargin-bottom:0in;margin-left:.5in;margin-bottom:.0001pt;mso-add-space:auto;text-indent:-.25in;line-height:normal;mso-list:l0 level1 lfo2"> ?????????Reimbursement-relatedexperience in two or more of the following areas:margin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;mso-add-space:auto;text-indent:-.25in;line-height:normal;mso-list:l0 level2 lfo2"> o??Medicaldevice reimbursementmargin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;mso-add-space:auto;text-indent:-.25in;line-height:normal;mso-list:l0 level2 lfo2"> o??Physician-administeredinjectablesmargin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;mso-add-space:auto;text-indent:-.25in;line-height:normal;mso-list:l0 level2 lfo2"> o??CPTIII reimbursementmargin-bottom:0in;margin-left:1.0in;margin-bottom:.0001pt;mso-add-space:auto;text-indent:-.25in;line-height:normal;mso-list:l0 level2 lfo2"> o??Productlaunch, with minimal to no payer coverage/reimbursementnormal"> margin-bottom:0in;margin-left:.5in;margin-bottom:.0001pt;mso-add-space:auto;text-indent:-.25in;line-height:normal;mso-list:l0 level1 lfo2"> ?????????Strongmedical reimbursement experience with HUB reimbursement services and specialty pharmacydistributionmargin-bottom:0in;margin-left:.5in;margin-bottom:.0001pt;mso-add-space:auto;text-indent:-.25in;line-height:normal;mso-list:l0 level1 lfo2"> ?????????Experience with benefit verifications, prior authorizations,claim assistance, and appealsmargin-bottom:0in;margin-left:.5in;margin-bottom:.0001pt;mso-add-space:auto;text-indent:-.25in;line-height:normal;mso-list:l0 level1 lfo2"> ??Payer/insurance coverage experiencewith Medicare, Medicare Advantage, Commercial and Medicaid plans?EssentialSkills and Abilities?????????Extensive customer service experience?????????Provenability to achieve objectives and corporate goals with minimal directsupervision?????????Excellenttime management skills?????????Demonstratedcreativity, situational analysis/problem solving, and analytical skills?????????Excellentcommunication skills, including written, verbal, and listening?????????Strongpresentation and training skills?????????Outstandinginterpersonal skills, including genuine care and concern for others?????????Provenability to establish and maintain customer and colleague relationships?????????Highlevel of emotional intelligence and maturity?????????Goodjudgment and a positive attitude in a changing and dynamic environment?????????Demonstratedleadership and project management skills?????????Broadbusiness perspective, including an advanced working knowledge of physician officeand surgical facility operations and systems?????????Desireto travel, with approximately 50 percent overnight travel including someweekend work?????????Provenreimbursement subject matter expertise in the following:o??CPTCodes (Category I & III)o??ICD-10Codeso??Medicare,Medicare Advantage, Commercial and Medicaid payer policyo??Billingand coding clinical operations (eye care experience a plus)o??HUBreimbursement service programso??Compliance
?????????Recognizedexperience in:o??Accountmanagemento??Customerneeds assessment, probing, and problem solvingo??Businessdevelopment planning and client business reviewso??Educationand trainingo??Priorityand time management (with travel)