Field Reimbursement Manager

This is a fully remote position, open to applicants in United States.

📋 Description

• Engage with healthcare providers and their office teams to provide education on accessing prescribed treatments through the specialty pharmacy channel.

• Address inquiries regarding initial access, insurance approvals, and reauthorizations necessary for product initiation.

• Educate healthcare provider office staff on the processes of prior authorization and appeals, including necessary forms, submission procedures, and reauthorization requirements.

• Develop and implement educational frameworks tailored for Clinical Specialists and District Managers to address access challenges.

• Identify and resolve patient access and reimbursement issues within the designated geographical area.

• Provide accurate process information utilizing PHI with the requisite patient consent.

• Act as a reimbursement expert for patient support services teams within the assigned geography and plans.

• Utilize approved resources, call guides, and FAQs to deliver education and respond to inquiries.

• Review payer policies and share policy insights with stakeholders and leadership within the client organization.

• Virtually manage assigned accounts while aligning with key stakeholders regarding support needs.

• Document call details meticulously, ensuring data integrity and compliance.

• Navigate the CRM platform and familiarize yourself with internal team processes.

• Uphold PHI confidentiality and adhere to applicable laws, regulations, and company policies.

• Direct escalations to manufacturer leadership in accordance with program design and business rules.

• Complete necessary training and comply with Inizio and client policies, procedures, business rules, call guides, and relevant laws.

⛳️ Requirements

• BS/BA degree.

• Demonstrated success in operating within a virtual environment.

• A minimum of 3 years of relevant experience in reimbursement and patient access, market access, specialty pharmacy, or physician/system account management.

• At least 5 years of overall experience in the healthcare industry.

• Proven experience engaging healthcare provider staff in a support capacity to educate on access pathways and product requirements.

• Familiarity with navigating the payer reimbursement process, including commercial and Medicare Part D.

• Experience with specialty products obtained through specialty pharmacy networks.

• Preferably, experience in ophthalmology and with self-injectable products.

• A patient-centric and service-oriented mindset, demonstrating emotional intelligence and empathy.

• Exceptional interpersonal and listening skills.

• Strong written, verbal, and presentation abilities.

• Robust business acumen.

• Capability to achieve common objectives in collaboration with therapeutic specialists, sales leadership, market access, and patient support services colleagues.

• Highly organized with excellent attention to detail and multitasking capabilities.

• Proficient in Microsoft Office (Word, Excel, PowerPoint, Outlook) and Google Suite Products.

• Proficiency in English is required; Spanish is highly preferred.

🏝️ Benefits

• Comprehensive benefits package including medical, dental, and vision coverage.

• Accrued paid time off.

• 401(k) plan with company matching.

• Disability and life insurance coverage.

• Paid maternity and paternity leave.

• Company-paid holidays.

• Recognition programs, contests, and awards.

• Continuous growth opportunities through learning, leadership development, and career advancement support.

• A collaborative culture where ideas are appreciated.