Access and Reimbursement Manager

Access and Reimbursement Manager

The Access and Reimbursement Manager (ARM) is a field-based position and will report to the Director of Payer Access and Reimbursement. 

This role focuses on minimizing reimbursement barriers for patients and providers.

Key activities include working directly with:

• Inpatient hospital billing/reimbursement staff.
• Outpatient office billing/coding support staff.
• Third-party vendors (HUB, Patient Assistance Programs, etc.).
• Other stakeholders involved in supporting patient access to Omeros products.

This position will work cross-functionally with Sales, Marketing, Market Access, and Commercial Operations to ensure timely insights, challenges and strategies are shared.  The ARM is expected to have a deep working knowledge in the reimbursement landscape, payer reimbursement processes, and be proficient in the latest industry reimbursement best practices, trends and news. 

Good things are happening at Omeros!

Come join our Marketing Team!

Who is Omeros?

Omeros is an innovative biopharmaceutical company committed to discovering, developing, and commercializing first-in-class small-molecule and protein therapeutics for large-market and orphan indications targeting immunologic disorders, including complement-mediated diseases and cancers, as well as addictive and compulsive disorders. Omeros’ lead MASP-2 inhibitor narsoplimab targets the lectin pathway of complement and is the subject of a biologics license application under review by FDA and EMA for the treatment of hematopoietic stem cell transplant-associated thrombotic microangiopathy. Omeros’ long-acting MASP-2 inhibitor OMS1029 has successfully completed Phase 1 single- and multiple-ascending dose clinical studies. OMS906, Omeros’ inhibitor of MASP-3, the key activator of the alternative pathway of complement, is in clinical development for paroxysmal nocturnal hemoglobinuria and complement 3 glomerulopathy. Funded by the National Institute on Drug Abuse, Omeros’ lead phosphodiesterase 7 inhibitor OMS527 is in clinical development for the treatment of cocaine use disorder. Omeros also is advancing a broad portfolio of novel cellular and molecular immuno-oncology programs. For more information about Omeros and its programs, visit www.omeros.com.

Commercial Team Culture

The successful candidate will be joining a strong Commercial Team that cultivates an energizing culture with a focus on the patient.   The Commercial Team culture goals are:  Win as a Team, Results & People Matter, We can and WE WILL do this, and We are accountable.  

What are your job responsibilities?

Your responsibilities in this position will include:

• Educate inpatient and outpatient billing, coding, office managers and other care team members on coding, billing, coverage and reimbursement to optimize access to Omeros therapies.
• Collaborate with members of the Omeros field team—including Transplant Clinical Account Managers, Market Development Managers, and Sales Business Directors and National Payer Account Managers—to develop and execute overall account strategies, ensuring consistent and aligned education on reimbursement and patient access.
• Liaise with the entire Market Access department including HUB Services, distribution services, other Omeros staff, and inpatient/outpatient staff to identify and resolve trending issues regarding patient access to Omeros products.
• Identify and develop short-term & long-term strategic account plans, programs, services focusing on increasing education at the HCP level regarding reimbursement / access methods for patients.
• Proactively communicate Omeros specific reimbursement programs, coding/billing, policies, procedures, and resources to HCP personnel related to access; the majority of time is spent on customer engagement.
• Monitor, analyze, and triage situations which may adversely impact patient access to therapy and provide timely feedback to internal/external customers.
• Collaborate with Patient Services (HUB), Specialty Pharmacy, and other reimbursement entities on individual case management needs related to HCP education on reimbursement issues.
• Collaborate closely with Field Payer teams on coverage policy developments
• Establish relationships with key institution/hospital, physician office, specialty pharmacy and other personnel associated with coding, billing, reimbursement and provide reimbursement-related support (Coding, Billing, Payment, Policy).
• Comply with all federal/state/local laws, regulations and guidelines including but not limited to the PhRMA Code on Interactions with Healthcare Professionals as well as complying with all Omeros standards and policies relating to all job activities.
• Other duties as assigned.

What education and experience do you need?

• BA/BS Degree with at least 7-10 years of pharmaceutical experience.
• Preferred minimum of 5 years’ experience in reimbursement/payer access.
• Experience with injectable or infused oncology/hematology or specialty products that are administered “incident to” a physician service (reimbursed as a medical benefit) is required; buy and bill experience required.
• Product launch experience in the US; experience in oncology/hematology/transplant and/or ultra-rare disease is highly desirable.
• Experience with drugs with restricted (limited or exclusive) distribution networks, specialty pharmacy, and/or HUB models is preferred.
• Advanced understanding of healthcare, payers, hospital formulary, coverage, reimbursement issues, specialty pharmacy state laws, and compliance laws and regulations.
• Must have demonstrated a high level of proficiency in communication skills, critical thinking / decision-making, influence, problem solving, and impact, planning and organization.
• Clinical knowledge in one or more of the following therapeutic areas preferred: Oncology; Hematology; Blood and Marrow Transplant.
• Strong background for products on the medical benefit and how that impacts reimbursement by different payer types (Commercial, Medicare, Medicaid).
• Demonstrated ability to work collaboratively with Sales, Marketing, Market Access, and National Accounts teams to ensure product access.
• Strong communication and educational skills with both internal and external customers that results in product access.
• Demonstrates good verbal and written communication skills to provide updates, direction, information, and clarification in a timely manner.
• Strong Microsoft Office skills (Excel and PowerPoint)
• Ability to be flexible and manage change within a dynamic growing organization and an evolving health care marketplace as needs dictate.
• Strong analytical skills 

What We’re Looking for in an Ideal Candidate:

• Demonstrated ability to build and maintain positive relationships with management and peers.
• Operate with integrity, trust, and honesty
• Ability to address and manage conflicts with internal and external customers.
• Demonstrate positive working relationships through emotional intelligence at various levels of the organization.

Other things you’ll need to know:

• This position requires domestic travel, approximately ~80% of the time.

Physical Demands Required: 

• Intermittent physical activity including bending, reaching, pushing, pulling, or lifting up to 20 lbs.
• May encounter prolonged periods of sitting.

Compensation and Benefits:

Omeros is proud to offer a competitive total compensation package designed to support the lives of our employees and their families. The wage scale for Access and Reimbursement Manager position is ($185,000 - $210,000). Salaries will be determined based on knowledge, skills, education, and experience relevant to the role. Employees are offered medical, dental, vision, life insurance, and a 401(k) plan with a company match. Employees accrue three weeks of vacation and 80 hours of sick time on an annual basis and receive twelve paid holidays throughout the calendar year. This position is eligible for incentive and stock options. To learn more about Omeros, please visit www.omeros.com. 

Omeros is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status such as race, religion, color, national origin, sex, age, marital status, or any other factor determined to be unlawful by federal, state, or local statutes.

It is our policy to provide reasonable accommodation to anyone with a disability who needs assistance completing the job application process. If you need assistance, you can either send an e-mail to [email protected] or contact Omeros, asking for Human Resources, at (206) 676-5000.