Summary
The Associate Director, Coverage & Access will be responsible for overseeing a designated team of Coverage & Access Supervisors. The successful candidate will be responsible for monitoring the team's performance in accordance with enterprise Service Level Agreements (SLAs), Key Performance Indicators (KPIs), and agent metrics. Additionally, the Associate Director will serve as a subject matter expert on enterprise Coverage & Access activities and will have a crucial role in ensuring the compliance of the designated Coverage & Access Specialists team with Novartis policies and procedures. Collaborating closely with other Associate Directors and teams such as Case Management, Central Operations, Performance Excellence.
About the Role
Key Responsibilities:
- Responsible for the daily operations of all aspects of the Coverage & Access Specialist team under their realm of leadership including performance, engagement, people management (growth/coaching/motivation), adherence to agent/company policies/processes, and serves as a systems (Salesforce) and Coverage & Access SME for their direct and indirect reports.
- Demonstrates the ability to problem solve operational and customer services impacts to provide clear, concise direction for all associated Coverage and Access Specialists and Supervisors.
- Oversee Supervisors that directly manage and support a team of 10-14 Coverage & Access Specialists each, ensuring operational excellence and aligning with SLAs, KPIs, and agent-specific metrics. Team focus and responsibilities will be one of three areas: Benefits Investigation, Coverage Exceptions or Annual Reverification; however, this role will be expected to have the ability to lead any/all aspects.
- Serves as a Coverage & Access SME for the Learning & Development and Documentation teams on the design, documentation, and administration of role, process, and systems-based trainings, including simulations and certifications.
- Provides oversight of the Supervisor team to ensure coaching for the Coverage & Access Specialists addresses trends identified during audits and calibrations.
- Collaborates with the brand-specific Associate Director, Case Management and other PSC business leads to address reimbursement functions within the patient journey.
- Partners with Central Operations functions for Customer Relations Management (CRM) system operations, technical escalations, and optimization.
- Partners with Director, Coverage & Access to identify operational and technical areas of opportunity. Maintain knowledge of industry trends and best practices.
- Collaborates with Performance, Quality, and Excellence (PQE) to monitor call and system performance of Coverage & Access Specialists. Ensure monitoring outcomes are executed at the in-dividual and team level. Schedule coaching, huddles and other sessions to positively impact overall performance and compliance of team.
- Responsible for identifying and reporting adverse events via the established Novartis systems as per applicable processes
Essential Requirements:
- Education: Bachelor’s Degree required; advanced business degree (MBA) preferred
- 5+ years of pharmaceutical industry or related consulting experience
- 2+ years of people management/leadership experience
- Comprehensive knowledge of patient support offerings including benefits verification (pharmacy and/or medical), and payer coverage exception strategies (Prior Auth/Appeal)
- Knowledge of HIPAA regulations, patient privacy, and other Novartis policies
- Strong analytical acumen and ability to apply data driven insights for operational improvements
- Thorough understanding and knowledge of US healthcare economics and the drivers of pharmaceutical demand
- Strategic thinker who can adapt and grow with the evolving Novartis Patient Support landscape
- Proficient in Microsoft Office tools (PowerPoint, Excel) and CRM systems (e.g. Salesforce)
Desirable Requirements:
- Previous management of a Coverage & Access hub or manufacturer team
- Experience with obtaining benefits for rare/orphan, gene therapy, or radio ligand products
The pay range for this position at commencement of employment is expected to be between $126,000 and $234,000 per year; however, while salary ranges are effective from 1/1/25 through 12/31/25, 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.
Why Novartis: Helping people with disease and their families takes more than innovative science. It takes a community of smart, passionate people like you. Collaborating, supporting and inspiring each other. Combining to achieve breakthroughs that change patients’ lives. Ready to create a brighter future together? https://www.novartis.com/about/strategy/people-and-culture
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EEO Statement:
The Novartis Group of Companies are Equal Opportunity Employers. We do not discriminate in recruitment, hiring, training, promotion or other employment practices for reasons of race, color, religion, sex, national origin, age, sexual orientation, gender identity or expression, marital or veteran status, disability, or any other legally protected status.
Accessibility & Reasonable Accommodations
The Novartis Group of Companies are committed to working with and providing reasonable accommodation to individuals with disabilities. If, because of a medical condition or disability, you need a reasonable accommodation for any part of the application process, or to perform the essential functions of a position, please send an e-mail to us.reasonableaccommodations@novartis.com or call +1(877)395-2339 and let us know the nature of your request and your contact information. Please include the job requisition number in your message.
