Field Reimbursement Manager-Chicago, IL

Company Overview

ViiV Healthcare is a global specialty HIV company, the only one that is 100% focused on researching and delivering new medicines for people living with, and at risk of, HIV.

ViiV Healthcare is highly mission-driven in our unrelenting commitment to being a trusted partner for all people living with and affected by HIV.

Our aim is to think, act, and connect differently through a focus on education on for the prevention and treatment for HIV.

We go to extraordinary lengths to deliver the sorts of breakthroughs, both in prevention, treatments, care solutions and communities, that really count.

We go beyond the boundaries of medicine by taking a holistic approach to HIV through developing and supporting sustainable community programs and improving access to care.

We are fully committed to push through every challenge until HIV / AIDS is eradicated. ViiV Healthcare has played a significant part in delivering breakthroughs that have turned HIV into a manageable health condition.

We offer the largest portfolio of HIV medicines available anywhere, and we continue our work to cater for the widest possible range of needs in response to the HIV epidemic.

We are aware of how much is at stake for those at-risk or affected by HIV and we show up every day 100% committed to the patients.

Our work culture is fast-paced, diverse, inclusive, competitive, and caring. But ViiV Healthcare isn’t just somewhere to work it’s a place to belong, an invitation to bring your very best, and a team full of impact-driven team members who are hungry to make a difference.

While we have been improving lives of HIV patients for 30 years, this is an especially exciting time to be at ViiV Healthcare, as we evaluate novel approaches to treatment and prevention that could further reduce the impact of HIV on individuals and communities.

Job Details

Are you energized by a highly visible role within the managed markets environment, that allows you to help fulfill our mission to leave no person living with HIV behind?

If so, this Field Reimbursement Manager role could be an ideal opportunity to consider.

The Field Reimbursement Manager will provide external and internal reimbursement and access support for ViiV Healthcare (VHC) products within a specified geographic region.

This position is a customer-facing, field-based role responsible for supporting appropriate patient access to ViiV Healthcare products, including coverage coding and payment assistance. The FRM will :

• Educate providers about important product reimbursement information and processes across settings of care.
• Review key payer policies, coverage and authorization criteria with prescribing providers and their staff.
• Communicate ViiV Access Support Services that may be available to help appropriate patients access ViiV Healthcare medicines.
• Review acquisition options (specialty pharmacy and buy-and-bill) and potential implications to the facility / practice and patient.
• Compliantly discuss applicable coding necessary for claim submission (HCPCS, CPT, ICD-10, billable units).
• Act as the primary access and reimbursement resource for internal field counterparts.
• Work with colleagues across the business to assess the access landscape, changing insurance dynamics and patient journey.
• Lead regional matrix partner calls to review regional activity, access barriers and opportunities.
• Serve as an integral member of the ViiV field team with a primary focus on ensuring each appropriate patient leverage healthcare coverage and ViiV support programs to maximize access to ViiV Healthcare medicines.
• Engage Medicare Administrative Contractors to ensure appropriate coverage of VHC products.

Basic Qualifications :

• Bachelor’s Degree
• Ability to travel up to 75% including overnights
• Must be located within 50 miles of a major airport in or near the territory
• Valid driver’s license.
• Minimum of 5 years’ experience in pharmaceutical and / or health care industry (must include experience in a specialty division) with at least 3 years in field reimbursement, payer marketing, patient support programs and / or reimbursement HUB programs.

Preferred Qualifications :

• MBA, MPH or other advanced degree
• Strong knowledge of the payer environment including state, federal, private third-party reimbursement issues, methodologies and policies for physician-administered drugs
• Strong customer focus with building relationships, issue identification and resolution, problem-solving and project management skills
• Ability to operate independently and handle multiple projects with a high degree of initiative and operate successfully in matrix environment reporting into reimbursement function while deployed in the field
• Highly organized, strategic thinker with excellent verbal, written and presentation communication skills
• Reimbursement experience for specialty injected / infused products in a buy and bill setting across all sites of care
• Strong knowledge of provider office and hospital outpatient department reimbursement environments, regulations, customers, and market dynamics.
• Strong knowledge of Specialty Pharmacy providers and relevant access dynamics
• Comprehensive understanding of Medicare Parts A, B, C, D and knowledge of commercial insurance reimbursement.
• Understanding of the miscellaneous and permanent J code, Q code and possible issues surrounding appropriate billing.
• Experience working with reimbursement call centers in support of patient access

LI-GSK

LI-ViiV

Please visit to learn more about the comprehensive benefits program ViiV offers US employees. All ViiV employees receive the same benefits options and plans as GSK employee.

Why Us?

At ViiV Healthcare, we will not rest until we leave no person living with HIV behind. Until the 39 million people living with HIV is down to zero, we will continue searching for new ways to limit the impact of HIV.

We are the only pharmaceutical company solely focused on combating, preventing, and ultimately eradicating HIV and AIDS.

At ViiV Healthcare, we do things differently. Born out of a partnership between and in 2009, with joining in 2012, we are determined to help end the HIV epidemic.

We are guided by our mission to leave no person living with HIV behind and it is this mission that unites our employees located across the globe.

We combine expertise in research, manufacturing, policy and more to push the boundaries of what people think is possible in HIV treatment and care.

As a result of our connection with GSK, we are able to draw on their proud history and resources. This means that you would receive all the employee benefits offered by GSK.

Living our mission of leaving no person living with HIV behind means keeping inclusion and diversity at the heart of everything we do - from our breakthrough innovation, to our diverse portfolio of medicines as well as the work we do to partner with HIV communities.

Having a diverse team and a truly inclusive culture where we’re all able to be ourselves and feel like we belong will make us an even stronger team, better able to perform as a business and deliver on our mission to leave no person living with HIV behind.

ViiV is an Equal Opportunity Employer and, in the US, we adhere to Affirmative Action principles. This ensures that all qualified applicants will receive equal consideration for employment without regard to race, color, national origin, religion, sex, pregnancy, marital status, sexual orientation, gender identity / expression, age, disability, genetic information, military service, covered / protected veteran status or any other federal, state or local protected class.

Important notice to Employment businesses / Agencies

ViiV does not accept referrals from employment businesses and / or employment agencies in respect of the vacancies posted on this site.

All employment businesses / agencies are required to contact ViiV's commercial and general procurement / human resources department to obtain prior written authorization before referring any candidates to ViiV.

The obtaining of prior written authorization is a condition precedent to any agreement (verbal or written) between the employment business / agency and ViiV.

In the absence of such written authorization being obtained any actions undertaken by the employment business / agency shall be deemed to have been performed without the consent or contractual agreement of ViiV.

ViiV shall therefore not be liable for any fees arising from such actions or any fees arising from any referrals by employment businesses / agencies in respect of the vacancies posted on this site.