Remote Prior Authorization Pharmacist Jobs in Normal, IL

Job Description

Field Access Manager

The Field Access Manager (FAM) serves as the subject-matter expert on access related issues for healthcare professionals (HCPs) and healthcare organizations (HCOs), and will work cross-functionally with patient support, market access, and field sales to support timely patient access to therapy. The FAM will provide information to providers on access processes, reimbursement issues, and support patient assistance programs, all while ensuring compliance with healthcare regulations.

The FAM role is a remote/field-based role that proactively provides approved education to defined accounts within an assigned geography on matters related to access and coverage to facilitate appropriate patient access. The FAM will analyze access issues and act as the local access resource for HCPs and other field force personnel and region management, as permitted by policy. Where appropriate, the FAM will coordinate with the access hub concerning individual patient cases including patient access and coverage assistance, hub enrollment and overall coordination. The FAM will need to collaborate 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.

The FAMs will manage daily activities that support appropriate patient access. Activities include, but are not limited to:

Provide information and/or education to HCP accounts on patient access, including benefit verification, prior authorization process, appeals process, and patient support programs in both live and virtual formats
Analyze access trends
Partner cross-functionally to identify and address barriers to patient access and supporting patient satisfaction
Build collaborative, trusted relationships with internal stakeholders to support seamless patient access to therapy
Monitor payer trends to address access barriers
Provide access information to HCP offices
Provide access education to field teams upon approved direction.
Escalate and coordinate on access issues with third parties including hub vendor
Provide education and support on Specialty Pharmacy issues
Provide information to HCP offices on how the products are covered under the benefit design (Commercial, Medicare, Medicaid)
Answer questions about coverage, including payer-specific access questions
Maintain deep knowledge of regional and national market dynamics, and payer coverage policies.
Act as a subject matter expert on access and affordability challenges across various payer types, including Medicare, Medicaid, and commercial plans
Educate and update HCPs on key private and public payer coverage and changes that impact access for patients
Support patient access to the product by providing subject matter expertise on payer coverage issues impacting product access in a manner that complies with policies, processes and standard operating procedures
Educate HCP offices on the product hub program including, e.g., patient support offerings, financial assistance and hub educational resources
Demonstrate knowledge of and communicate information about access resources and payer processes/policies
Attend National and Regional Meetings
Minimum Requirements:
Bachelor's Degree; 7+ years' 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 diverse 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 20-25% travel; Must reside in the assigned territory/metro area
Ability to operate as a "team player" in collaborating with multiple sales representatives, sales leadership, and internal colleagues appropriately to reach common goals
Must be at least 21 years old with a valid driver's license and a clean driving record
Preferred Requirements:
Pharmaceutical industry experience highly preferred
Deep understanding of HCP office workflows, prescription flow, and clinic operations; pulmonology experience preferred

Required Skills:

Adaptability, Adaptability, Cost Effectiveness Analysis, Data Analysis, Direct Marketing, Health Care Regulation, Healthcare Reimbursement, Health Economic Modeling, Health Economics, Health Economics Research, Health Policy Analysis, Health Technology Assessment (HTA), Interpersonal Relationships, Market Access, Marketing, Market Research, Patient Access, Pharmaceutical Compliance, Pharmaceutical Guidelines, Pricing Processes, Public Affairs, Pulmonology, Sales Leadership, Stakeholder Relationship Management, Standard Operating Procedure (SOP) {+ 2 more}

Preferred Skills:

Current Employees apply HERE

Current Contingent Workers apply HERE

US and Puerto Rico Residents Only:

Our company is committed to inclusion, ensuring that candidates can engage in a hiring process that exhibits their true capabilities. Please click here if you need an accommodation during the application or hiring process.

As an Equal Employment Opportunity Employer, we provide equal opportunities to all employees and applicants for employment and prohibit discrimination on the basis of race, color, age, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability status, or other applicable legally protected characteristics.As a federal contractor, we comply with all affirmative action requirements for protected veterans and individuals with disabilities. For more information about personal rights under the U.S. Equal Opportunity Employment laws, visit:

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We are proud to be a company that embraces the value of bringing together, talented, and committed people with diverse experiences, perspectives, skills and backgrounds. The fastest way to breakthrough innovation is when people with diverse ideas, broad experiences, backgrounds, and skills come together in an inclusive environment. We encourage our colleagues to respectfully challenge one another's thinking and approach problems collectively.

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The salary range for this role is

$117,000.00 - $184,200.00

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

Search Firm Representatives Please Read Carefully
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.

Employee Status:

Regular

Relocation:

No relocation

VISA Sponsorship:

No

Travel Requirements:

25%

Flexible Work Arrangements:

Remote

Shift:

Not Indicated

Valid Driving License:

Yes

Hazardous Material(s):

n/a

Job Posting End Date:

08/4/2026

*A job posting is effective until 11:59:59PM on the day BEFOREthe listed job posting end date. Please ensure you apply to a job posting no later than the day BEFORE the job posting end date.