Remote Utilization Management Jobs in Temecula, CA

Headquartered in Carlsbad, California, and with offices in Boston, Massachusetts, and Dublin, Ireland, Ionis has been at work for more than three decades discovering medical breakthroughs that have redefined life for people with serious diseases. We're pioneers in RNA-targeted medicines, and our platform continues to revolutionize drug discovery and transform lives for patients with unmet needs. With multiple marketed medicines and a leading pipeline in neurology, cardiology and select areas of high patient needs, we continue to drive innovation in RNA therapies in addition to advancing new approaches in gene editing to provide greater value to patients and are well positioned financially to deliver on our strategic goals.
At Ionis, we pride ourselves on cultivating a challenging, motivating and rewarding environment that fosters innovation and scientific excellence. We know that our success is a direct result of the exceptional talents and dedication of our employees.
With an unprecedented opportunity to change the course of human health, we look to add diverse individuals, skill sets and perspectives to our exceptional team. We continue to invest time, money and energy into making our onsite, hybrid and remote work environments a place where solid and lasting relationships are built and where our culture and employees can thrive.
We're building on our rich history, and we believe our greatest achievements are ahead of us. If you're passionate about the opportunity to have meaningful impact on patients in need, we invite you to apply and join us. Experience and contribute to our unique culture while you develop and expand your career!
FIELD ACCESS MANAGER - TRYNGOLZA
SUMMARY:
The Field Access Manager (FAM) is a field-based role that will establish and maintain strategic relationships with providers and key office staff to support access needs. They will proactively provide education to defined accounts on a wide range of access and reimbursement topics and will be the local market access expert on payer policy and access requirements, patient services, and integration of support programs into their workflows. The FAM will be vital in helping customers navigate any access questions/challenges.
The FAM is a critical member of the Ionis commercial organization and will work with a variety of cross functional partners including customer facing teams, Market Access, Account Directors, Specialty Pharmacies (SPs), Patient Services and Marketing to deliver an exceptional customer experience.
RESPONSIBILITIES:
The ideal candidate will:

• Interact within assigned accounts to support patient access, providing proactive face-to-face (or virtual if appropriate) education on programs to providers and staff to support integration of those programs into office processes and workflows.
• Leverage data and analytical tools to address customer questions for issues related to payer policies and access requirements.
• Work with key members of customer accounts (e.g., providers, administrators, billing and coding staff, etc.) to appropriately support patient access.
• Address customer questions related to payer policies (e.g., utilization management, denial, and appeals) and patient reimbursement.
• Collaborate with aligned cross-functional partners (identified above) to share insights on customer needs and barriers related to access and reimbursement.
• Maintain a deep understanding of Ionis policies and requirements and perform all responsibilities with integrity and in a manner consistent with company guidance and prescribed Values and Behaviors.
• Handle Patient Identifiable Information (PII) appropriately (understand and ensure compliance with HIPAA and other privacy laws and regulations and internal Company compliance policies/guidelines).
• Responsible for identifying and reporting adverse events via the established Ionis systems as per applicable processes.
• 50% Travel required

QUALIFICATIONS:

• Minimum 8 years in the healthcare/pharmaceutical industry.
• Prior reimbursement or case management experience required (prior field access/reimbursement experience preferred).
• Experience with pharmacy benefit reimbursement/access and specialty pharmacy required
• CPC or similar coding certification preferred
• Experience working in the cardiometabolic area preferred
• Knowledge of key Medicare policies such as Part D design and IRA
• Proven teamwork and collaboration skills with a demonstrated track record of working in highly matrixed and cross-functional work teams.
• Ability to travel to meetings/trainings/programs as necessary - additional travel will be required within the assigned geography (~50% travel required depending on territory)
• Must live within assigned territory.
• Valid driver's license required as driving is fundamental to the purpose of this job and cannot be eliminated.

Education:

• Bachelor's Degree required
• Advanced degree preferred

Please visit our website, http://www.ionis.com for more information about Ionis and to apply for this position; reference requisition #IONIS004057
Ionis offers an excellent benefits package! Follow this link for more details: Ionis Benefits
Full Benefits Link: https://ionis.com/careers#:~:text=Highly%20competitive%20benefits
The pay scale for this position is $162,000 to $185,000
NO PHONE CALLS PLEASE. PRINCIPALS ONLY.
Ionis Pharmaceuticals, Inc. and all its subsidiaries are proud to be EEO employers.
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.
For further information, please review the Know Your Rights notice from the Department of Labor.