Prior Authorization Associate Jobs in Ohio (NOW HIRING)

Job Description

The Associate Director, Field Access Management serves as the leader to a team of subject-matter experts on access processes, reimbursement issues, and patient assistance programs for healthcare professionals (HCPs) and healthcare organizations (HCOs). In this role, you will work cross-functionally with Field Sales, Marketing, Market Access, Public Affairs, State and Government Affairs, Trade and Specialty Pharmacy Accounts while abiding by all corporate and industry policy and procedures.

As a people leader, you will cultivate an environment where collaboration, growth, and professional development are at the forefront. Your leadership will enable your team to leverage access expertise, build trusted relationships, and serve as the primary point of contact for FAMs in your region. Join a mission-driven organization to help coach, mentor, and inspire others.

Key Responsibilities:
Train, educate, coach, and lead a team of Field Access Managers (FAMs).
Execute the field access strategy and oversee the success of the Field Access Management Team for which you are responsible.
Understand Regional Payor and Medicaid coverage and provide market access education via approved materials to the Field Access Management team.
Assist with ongoing maintenance of standard operating procedures (SOPs) regarding Hub, specialty pharmacy, field access managers, and appropriate interactions with field sales teams to support appropriate access to therapy.
Provide proactive field-based access education to internal and external stakeholders by identifying and educating around access issues and sharing successes.
Educate and communicate technical knowledge of patient enrollment process, payer coverage policies, prior authorization process, appeals process, patient support programs, and Hub operations to Field Access Management team.
Participate in cross-functional meetings with sales, market access, and marketing to ensure alignment and understanding of the access landscape, issues, and field access strategy.
Minimum Requirements:
Bachelor's Degree; 5+ years in the pharmaceutical/biotech industry.
Minimum 3 years of experience in patient support, healthcare sales or operations, project management, or reimbursement support.
Strong knowledge of health insurance structures (Medicare Part B, Medicaid, commercial) and related access processes, including benefit verification, prior authorization, and appeal processes.
Expertise in pharmaceutical compliance and HIPAA regulations regarding patient confidentiality.
Excellent interpersonal and communication skills; demonstrated ability to engage and influence multiple stakeholders across teams and disciplines.
Exhibit competent understanding of hub and patient support activities.
Proven ability to manage multiple priorities in a hybrid environment with 30-35% travel; Must reside in the assigned territory/metro area.

Required Skills:

Preferred Skills:

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The salary range for this role is

This is the lowest to highest salary we in good faith believe we would pay for this role at the time of this posting. An employee's position within the salary range will be based on several factors including, but not limited to relevant education, qualifications, certifications, experience, skills, geographic location, government requirements, and business or organizational needs.

The successful candidate will be eligible for annual bonus and long-term incentive, if applicable.

We offer a comprehensive package of benefits. Available benefits include medical, dental, vision healthcare and other insurance benefits (for employee and family), retirement benefits, including 401(k), paid holidays, vacation, and compassionate and sick days. More information about benefits is available at https://jobs.merck.com/us/en/compensation-and-benefits.

You can apply for this role through https://jobs.merck.com/us/en (or via the Workday Jobs Hub if you are a current employee). The application deadline for this position is stated on this posting.

San Francisco Residents Only:We will consider qualified applicants with arrest and conviction records for employment in compliance with the San Francisco Fair Chance Ordinance

Los Angeles Residents Only:We will consider for employment all qualified applicants, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance

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Merck & Co., Inc., Rahway, NJ, USA, also known as Merck Sharp & Dohme LLC, Rahway, NJ, USA, does not accept unsolicited assistance from search firms for employment opportunities. All CVs / resumes submitted by search firms to any employee at our company without a valid written search agreement in place for this position will be deemed the sole property of our company. No fee will be paid in the event a candidate is hired by our company as a result of an agency referral where no pre-existing agreement is in place. Where agency agreements are in place, introductions are position specific. Please, no phone calls or emails.

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