Field Reimbursement Manager

This is a fully remote position, open to applicants in Illinois, +5 more states.

📋 Description

• Facilitate patient access to innovative therapies by leveraging expertise in coverage, payer policies, and patient assistance programs.

• Educate and collaborate with office staff to navigate the access journey and identify effective solutions.

• Offer personalized issue resolution through the dedicated patient support hub and specialty pharmacy team.

• Work together with local and regional sales teams to support targeted accounts.

• Exhibit a profound understanding of reimbursement and access as the subject matter expert within the assigned territory.

• Analyze the geographic presence and influence of managed care accounts, including payer mix, product coverage, and reimbursement criteria.

• Inform providers about prior authorization, coverage status, payer appeals, alternate funding options, processes, and timelines.

• Provide access education to healthcare professionals and office staff.

• Act as a liaison between sales representatives and key external clients.

• Foster relationships with healthcare professionals (HCPs), HCP-office stakeholders, and healthcare systems.

• Assist customers in navigating specialty pharmacy distribution.

• Collaborate daily with specialty pharmacy case management to ensure accurate coverage determinations and timely access to products.

• Identify accounts and patients facing delays due to reimbursement or insurance challenges.

• Develop and implement innovative solutions for patient access.

• Conduct strategic analyses and create business plans highlighting issues and opportunities.

• Meet with customers, attend relevant conferences, and travel with sales and regional colleagues.

⛳️ Requirements

• B.S./B.A. degree or higher with 8+ years of experience in the pharmaceutical or biotechnology industry, particularly in biotech drug distribution across specialty distributors, specialty pharmacies, and hospital systems.

• Proven understanding of coverage and reimbursement processes for both oral and injectable therapies.

• Strong expertise in Specialty Pharmacy operations and third-party services (Patient Support).

• In-depth knowledge of payer/PBM utilization management tactics for new therapies, including new-to-market blocks and exclusion lists.

• Comprehensive understanding of pharmaceutical manufacturer compliance, patient confidentiality, product reimbursement, and access requirements.

• Familiarity with regulations and laws that safeguard patient identifying information and access offerings.

• Strong sense of urgency and self-motivation, complemented by clear and concise written and verbal communication skills.

• Proven cross-functional influencing experience across commercial, medical, clinical, and external stakeholder groups.

• Ability to adapt to dynamic environments, balance competing priorities, and respond to ambiguity and unforeseen challenges with professionalism and sound judgment.

• Extensive knowledge of laws and regulations governing the contracting and pricing of pharmaceutical products.

• Experience in managing long-term enterprise-level relationships and navigating complex contract negotiations and contract execution.

• Deep understanding of and compliance with OIG and FDA regulations governing pharmaceutical marketing and the PhRMA code.

• Excellent communication skills with stakeholders at all organizational levels and a persuasive, credible presentation style.

• Significant travel availability, up to approximately 70% of the time.

• Launch experience, particularly with oral specialty drugs, is highly valued; experience with rare diseases is a plus.

• Familiarity with and understanding of other commercial functions is an important consideration.

🏝️ Benefits

• Comprehensive health insurance options.

• Competitive salary and performance-based bonuses.

• Opportunities for professional development and career advancement.

• Flexible work arrangements and a supportive work environment.