Description:
The Access Care Manager (ACM) serves as a field-based access leader responsible for integrating patient journey ownership, reimbursement expertise, and account-level strategy to ensure appropriate patient access. This role combines high-touch patient engagement with advanced subject matter expertise in reimbursement, payer policy, and coverage strategy, acting as a trusted partner to healthcare providers and internal stakeholders.
Role Responsibilities
Patient Journey Leadership & Case Management
- Serve as the primary point of contact for consented patients across the treatment journey from enrollment through therapy initiation and continuation.
- Conduct patient needs assessments addressing coverage, affordability, and logistical barriers to access for consented patients.
- Assist in coordinating care across healthcare providers, caregivers, and sites of care to ensure continuity and timely progression to therapy for consented patients.
- Maintain accountability for end-to-end patient progression, ensuring proactive identification and resolution of barriers.
Reimbursement Subject Matter Expertise
- Act as a field-based expert on reimbursement, coverage pathways, and payer policy impacting Pfizer therapies.
- Provide guidance on the prior authorization process, step edits, coding, and payer-specific requirements.
- Support the resolution of reimbursement challenges through appropriate escalation and coordination.
HCP Education & Training
- Deliver compliant education on reimbursement processes, coverage pathways, and patient access resources, including hub services, enrollment processes, and financial assistance programs to improve access efficiency.
Account-Level Strategy & System Optimization
- Develop and execute account-level access strategies to improve patient access at scale.
- Identify systemic barriers and implement solutions to optimize workflows and assist in reducing delays in therapy initiation.
Payer Interaction & Access Resolution
- Engage with payer organizations, as appropriate, to clarify coverage policies and support resolution of access challenges.
- Facilitate communication between HCP offices, payers, and patient support programs to ensure efficient navigation of the reimbursement process.
Internal Strategic Influence & Market Insights
- Provide actionable insights on payer trends, reimbursement challenges, and access barriers to internal stakeholders.
- Support development of cross-functional strategies by translating field insights into recommendations.
- High degree of Business Acumen and deep understanding of market dynamics and drivers in the Access space and accounts.
Cross-Functional & Commercial Alignment
- Collaborate with Sales, Key Account Managers, Marketing, and Patient Solutions teams to ensure aligned execution of access strategies.
- Participate in account planning and contribute to coordinated, patient-centric approaches to access.
Basic Qualifications
- 8+ years of pharmaceutical (or related) experience in customer-facing roles/functions, 9 with Masters, BSN or Rph
- 1+ years in Access and Reimbursement support role
- Minimum 3–5 years of Specialty Pharma experience, preferably within the Pharmaceutical/ Biopharmaceutical sectors, Provider/Carrier Networks, or Government Agency. Reimbursement and Access experience is a must and experience in the Endocrinology or Immunoglobulin sector is preferred.  Strong understanding of Reimbursement, Government Payment Systems, Provider/Carrier Networks, Co-Pay Assistance Programs, and knowledge of the Specialty policy dynamics that exist in the Rare Disease Community.
- Experience demonstrating exceptional communication and presentation skills, strategic planning and success in implementation of plans. This individual must also have demonstrated leadership and success at working across internal boundaries and be able to collaborate with multiple stakeholders to coordinate various unique objectives.
- Demonstrated ability to work in a highly regulated environment and adhere to strict company compliance guidelines and procedures. Proven track record of collaborating broadly with a diverse range of customers, clients, and stakeholders. Training in and experience in responsible business communication both written and spoken.
- Valid US driver’s license and driving record in compliance with company standards. Any DUI/DWI or other impaired driving citation within the past 7 years will disqualify you from being hired.
- Candidate demonstrates a breadth of diverse leadership experiences and capabilities including: the ability to influence and collaborate with peers, develop and coach others, oversee and guide the work of other colleagues to achieve meaningful outcomes and create business impact.