Senior Field Reimbursement Specialist- Cell and Gene Therapy/Rare Disease

Our team members are at the heart of everything we do. At Cencora, we are united in our responsibility to create healthier futures, and every person here is essential to us being able to deliver on that purpose. If you want to make a difference at the center of health, come join our innovative company and help us improve the lives of people and animals everywhere. Apply today! Job Details Please note: This position is open to qualified candidates located anywhere in the United States. Candidates are not required to reside in a particular state; however, they must live within a reasonable commuting distance of a major airport and be able to travel up to 80% as required by the role. T he Sr Field Reimbursement  Specialist (FRS)  will plan and engage with health systems, hospitals, academic medical centers, authorized treatment centers, and other institutional stakeholders to provide education on access, reimbursement, and operational considerations relevant to an assigned client’s rare disease cell and gene therapy (CGT) product. This role requires   demonstrated   experience working within health systems and navigating complex institutional reimbursement, treatment-site readiness, payer coverage, prior authorization, billing, coding, and patient access processes. The Sr FRS will serve as a field-based reimbursement and access   subject   matter   expert ,   leveraging   client-approved resources to support   appropriate product   access while   operating   in accordance with   established rules of engagement, client legal/compliance guidance, and applicable policies. The role will work within a matrix environment to collaborate with internal and external stakeholders, including client field teams,   payer /access teams, patient support program representatives, health system administrators, pharmacy teams, billing and finance teams, and clinical operations stakeholders.   Manage daily activities that support   appropriate patient   access to the client’s products within health systems, hospital outpatient departments, academic and community institutions, authorized treatment centers, and aligned provider offices. This role will act as a liaison to patient assistance, reimbursement support, and access services offered by the client, with a focus on helping institutional stakeholders understand product acquisition pathways, CGT-specific prior authorization requirements, site-of-care considerations, coding and billing requirements, denial and appeal processes, and operational logistics that may affect timely access for patients with rare diseases. The scope and approach to the activities are defined by the client’s legal and compliance departments and may vary.   Activities may include, but are not limited to:   Educate health systems, hospitals, academic medical centers, authorized treatment centers, and provider office staff on payer coverage, benefit design, and reimbursement considerations for rare disease and cell and gene therapy products   Validate and educate stakeholders on prior authorization requirements, including clinical eligibility criteria, site-of-care requirements, payer-specific medical necessity documentation, and appeal processes   Demonstrate understanding of specialty pharmacy, specialty distribution, buy-and-bill, and institutional acquisition pathways, including the unique operational considerations associated with CGT products   Educate institutional stakeholders on coordination needed to support product access, including infrastructure needed for treatment-site readiness, authorized treatment center certification, REMS obligations if applicable, patient cell collection, manufacturing timelines, product delivery scheduling, and monitoring requirements   Educate health system administrators, pharmacy teams, billing and finance teams, and provider office staff on coverage management strategies, product acquisition channels, formulary placement, coding, billing, prior authorization, denial, and appeal processes   Identify   alternate funding, financial   assistance , copay support, foundation support, and other   appropriate access   resources for eligible patients, consistent with client-approved guidance   Act as a subject matter expert on coverage,   payer   policy, product-specific codes, institutional reimbursement requirements, and patient-specific access questions, including CGT-related reimbursement considerations such as HCPCS/CPT codes, NTAP eligibility, pass-through payment status, and reimbursement gap mitigation strategies   Apply effective account management within complex health systems by uncovering customer insights,   identifying   account-level access barriers, using critical thinking and problem solving, and   disseminating   information to   appropriate internal   and external partners   Review and   educate on   appropriate billing   and coding considerations for   a   rare disease   /   CGT product, including institutional billing workflows, buy-and-bill requirements, and potential reimbursement gaps   relative   to acquisition cost   Probe to understand health system and office processes and discern root causes of access, reimbursement, treatment-site readiness, payer credentialing, or logistical barriers   Drive resolving reimbursement issues through an educational approach   Educate stakeholders on evolving CGT reimbursement   constructs , which may include outcomes-based agreements, installment or annuity payment models, value-based contracts, and applicable CMS payment models, as directed by the client   Monitor,   identify , and communicate local and regional payer coverage trends, including commercial payer criteria, Medicare and Medicaid considerations, local and national coverage determinations, and state Medicaid participation in applicable CGT access models   Coordinate with authorized treatment center site coordinators, pharmacy teams, cell collection centers, patient supp