Team Guide –Patient Support Center - East Hanover, NJ or Tempe, AZ

Your responsibilities will include, but are not limited to:

• Coordinate a team of payer-facing Coverage & Access Specialists with the responsibility of handling all aspect of the Coverage & Access case for multiple Novartis specialty brands, including benefit verification, prior authorization and appeals, etc. 

• Learn and utilize protocols, information, and technology to gather patient coverage information. Some of this will be completed via phone calls to payers in a prompt and courteous manner.

• Prepare proper documentation and notifications; perform proper escalation, tracking, and follow-up.

• Promptly respond to and address escalations related to the Coverage & Access portion of the patient journey.

• Drive improved efficiency and effectiveness of customer service to Associate Director of Coverage & Access- Annual Reimbursement.

• Monitor performance, attendance, and quality of the Coverage & Access Specialists you oversee to drive service excellence and KPI and SLA achievement through partnership with contractor vendor.

• Work closely with Performance Excellence to monitor call and system performance of Coverage & Access Specialists.  Ensure monitoring outcomes are addressed. 

• Identify trends in team performance to assist in identification of process improvements.

• Share and encourage best practices for supporting optimal Coverage & Access operations; foster a collaborative team environment; foster a culture of innovation.

• Along with the Associate Director of Coverage & Access, Annual Reverification, communicate regularly regarding policy changes, improvement opportunities, and Working Practice Document (WPD) changes.

• Work with cross functional partners in both the PSC and Novartis Patient Support (NPS) to ensure the Coverage & Access Specialist have all required information to perform effectively.

• In the ‘off season’ of Annual Reverification, this role is expected to work directly with the Associate Director of Coverage & Access- Annual Reimbursement to update Coverage & Access Specialist team documentation (Job Aids, Work Instructions, Training content, etc.), generally June – August of each year (subject to change).

• Coordinate with external vendor in staffing of Annual Reverification Coverage & Access Specialists that will be part of the team, generally June through September of each year.

• Attend and participate in Coverage & Access Specialist training as a subject matter expert for the upcoming Annual Reverification period.

Novartis Compensation and Benefit Summary: The pay range for this position at commencement of employment is expected to be between $88,000 and $132,000/year; however, while salary ranges are effective from 1/1/24 through 12/31/24, fluctuations in the job market may necessitate adjustments to pay ranges during this period. Further, final pay determinations will depend on various factors, including, but not limited to geographical location, experience level, knowledge, skills and abilities. The total compensation package for this position may also include other elements, including a sign-on bonus, restricted stock units, and discretionary awards in addition to a full range of medical, financial, and/or other benefits (including 401(k) eligibility and various paid time off benefits, such as vacation, sick time, and parental leave), dependent on the position offered. Details of participation in these benefit plans will be provided if an employee receives an offer of employment. If hired, employee will be in an “at-will position” and the Company reserves the right to modify base salary (as well as any other discretionary payment or compensation program) at any time, including for reasons related to individual performance, Company or individual department/team performance, and market factors.

What you’ll bring to the role:

• Education:

  • High School Diploma required; Associates or Bachelor’s degree preferred

• Travel requirements:

  • Proximity and ability to commute to work onsite in East Hanover, NJ or Tempe, AZ minimally 1 week per month and for occasional meetings or events including training

• Required Experience:

  • Two (2+) years of proven Reimbursement experience completing Reimbursement activities (benefit verifications, prior authorizations, billing/coding) with specialty products

  • Ability to interpret, capture and document the details of payer conversations, in a timely and efficient manner

  • Proven experience coaching/teaching/mentoring (formally or informally within a team dynamic)

  • Expertise working with data entry system(s), computer software, and telephone technology

  • Excellent phone and verbal communication skills – ability to follow oral and written directions

  • Ability to collaborate with Novartis field teams who may be responsible for reimbursement activities with customers, and share insights

  • For internal candidates currently in the Coverage and Access Specialist role, has demonstrated a strong performance in that role over previous 12 months and is in good standing, as evidenced by individual SLAs and productivity measures

  • Strong verbal communication skills – ability to follow and provide oral and written directions

  • Forward thinker who can adapt and grow with the evolving Patient Support Center landscape

• Desired Experience:

  • Prior experience working with contracted call center team

  • Prior experience leading a team in call center environment

  • Prior experience working on Annual Reverification coverage & access cases

• Therapeutic area experience

  • Specialty products experience

• Other Work Requirements:

  • When working from home, a quiet dedicated space where the employee can work without interruption

  • Ability to work the scheduled work hours, which generally will be an 8-hour schedule with two paid rest breaks and an unpaid lunch break.  Schedule 1 hours: 8 am – 5 pm ET (East Hanover, NJ); Schedule 2 hours: 10 am – 7 pm ET (Tempe, AZ), Monday through Friday. Schedule times are subject to change.

For Patient Support Center (PSC) roles with a dedicated training period: The individual hired for this role will be required to successfully complete initial training, including passing simulations and become certified to do the role, as well as support training sessions (as a subject matter expert) where Annual Reverification agents may be attending.

You’ll receive:

Competitive salary, annual bonus, health insurance, paid vacation/holidays, potential flexible working arrangements, subsidized dining facilities, employee recognition scheme.

Why consider Novartis?

769 million lives were touched by Novartis medicines in 2020, and while we’re proud of this, we know there is so much more we could do to help improve and extend people’s lives.

We believe new insights, perspectives and ground-breaking solutions can be found at the intersection of medical science and digital innovation. That a diverse, equitable and inclusive environment inspires new ways of working.

We believe our potential can thrive and grow in an unbossed culture underpinned by integrity, curiosity and flexibility. And we can reinvent what's possible, when we collaborate with courage to aggressively and ambitiously tackle the world’s toughest medical challenges. Because the greatest risk in life, is the risk of never trying!

Imagine what you could do here at Novartis!

Commitment to Diversity & Inclusion:

Novartis is committed to building an outstanding, inclusive work environment and diverse teams representative of the patients and communities we serve.

Join our Novartis Network: If this role is not suitable to your experience or career goals but you wish to stay connected to hear more about Novartis and our career opportunities, join the Novartis Network here: https://talentnetwork.novartis.com/network