Access and Reimbursement Senior Manager

Sumitomo Pharma Co., Ltd., is a global pharmaceutical company based in Japan with operations in the U.S. (Sumitomo Pharma America, Inc.), focused on addressing patient needs in oncology, urology, women's health, rare diseases, cell & gene therapies and CNS. With several marketed products and a diverse pipeline of early- to late-stage investigational assets, we aim to accelerate discovery, research, and development to bring novel therapies to patients sooner. For more information on SMPA, visit our website https://www.us.sumitomo-pharma.com or follow us on LinkedIn. Job Overview: This position reports to the Director, Access and Reimbursement and is part of the Market Access team, supporting SMPA’s Commercial Organization. This role serves as a field-based position responsible for supporting patient access to therapy by educating healthcare providers, office staff, health systems, and key stakeholders on reimbursement, coverage, coding, billing, and patient support programs. These roles serve as a subject matter expert on payer policies, access barriers, prior authorization requirements, claims adjudication, appeals processes, and patient affordability solutions, helping providers and staff navigate the complexities of obtaining appropriate patient access to prescribed therapies while maintaining compliance with all applicable legal, regulatory, and company standards. We are hiring four remote positions covering four main geographies: West, Central, Northeast and Southeast. In this role, you will partner cross-functionally with Market Access, Account Management, Patient Services, Sales, Medical Affairs, Compliance, Legal, and Operations to identify and address reimbursement challenges that impact patient initiation, adherence, and continuity of care. Essential Functions Required for Job Reimbursement Education & Support Serve as the field-based expert on reimbursement, coverage, coding, billing, claims submission, appeals, and patient access processes. Educate healthcare providers, office managers, reimbursement specialists, and health system stakeholders on payer requirements and reimbursement pathways. Provide compliant education regarding benefit verification, prior authorization requirements, appeal processes, coding updates, and coverage policies. Assist providers in understanding patient support programs, affordability solutions, and HUB resources. Patient Access Strategy Identify reimbursement and access barriers affecting patient treatment initiation and persistence. Develop and execute territory-level access plans to address market-specific reimbursement challenges. Monitor payer policy changes, coverage restrictions, utilization management criteria, and emerging reimbursement trends. Collaborate with Market Access and Patient Services teams to improve the customer experience and patient journey. Customer Engagement Build trusted relationships with physician practices, academic centers, integrated delivery networks, community providers, specialty pharmacies, and injection/infusion centers. Deliver educational presentations regarding reimbursement processes and access support resources. Respond to complex reimbursement inquiries and escalate unresolved issues through appropriate channels. Cross-Functional Collaboration Partner with Corporate Account Directors, Regional Account Directors, Market Access Marketing, Patient Services, Trade, Medical Affairs, and Commercial leadership to identify systemic access issues and recommend solutions. Provide field insights related to payer coverage, claims trends, reimbursement obstacles, and customer needs. Support product launches and new indication expansions through access readiness planning and field reimbursement education. Compliance & Governance Ensure all activities are conducted in accordance with healthcare laws, industry guidance, corporate compliance policies, and applicable promotional/non-promotional standards. Maintain accurate activity documentation and reporting. Participate in compliance and reimbursement training programs as required. Knowledge, Skills and Abilities (general & technical): Reimbursement Expertise Patient Access Strategy Payer Landscape Knowledge Provider Practice Operations External and Internal Customer Engagement, Empathy & Influence Cross-Functional Leadership Compliance Mindset Business Acumen Data Analysis & Insight Generation Executive Communication Education & Experience Requirements: Bachelor’s degree in a related field required. Minimum 6 years of relevant experience in biotech or pharmaceutical industry with a background in in reimbursement, patient access, market access, patient services, account management, or a related healthcare field Deep understanding of commercial, Medicare, Medicaid, VA, and specialty pharmacy reimbursement environments. Knowledge of medical and pharmacy benefit structures, prior authorization processes, coding systems, claims adjudication, and appeals pathways. Demonstrated success collaborating with provider offices, health systems, specialty pharmacies, and patient support programs. Strong presentation, communication, relationship management, critical thinking and problem-solving skills. Ability to travel extensively within assigned geography. Preferred Qualifications: Specialty pharmaceutical, biotechnology, oncology, neurosciences, rare disease, immunology, or specialty therapeutic experience. Experience launching specialty pharmaceutical products. Knowledge of HUB operations, patient assistance programs, and affordability offerings. Previous leadership or mentoring experience. Travel Requirements: 60-80% Travel Required Mental/Physical Requirements: Extensive travel: R egular travel throughout assigned territory—estimated 60–80% of working time—requiring long periods on the road and flexible scheduling. Overnight stays as part of business travel may be required depending on the territory. Mobility & stamina: Frequent in-person visits to physician offices, clinics, hospitals, and trade shows, requiring sustained driving, walking, standing, and sitting. Independent, field-based work: Ability to manage one’s schedule, work autonomously, and adapt to variable meeting locales (conference rooms, doctors’ offices, hotel spaces) Handling materials and samples: Transport of product samples, materials, and informational kits—lifting and carrying supplies between locat