Field Reimbursement Manager, Botox

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

📋 Description

• Provide education to healthcare providers and accounts regarding medical and pharmacy benefits, Buy & Bill, Specialty Pharmacy acquisition, payer policies, patient identification, clinical documentation, benefit investigations, prior authorizations, billing, coding, patient tracking, claim submission, reconciliation management, patient financial savings programs, retreatment, and processes related to denial/appeal for approved BOTOX Therapeutics indications.

• Identify and address barriers that could hinder or delay patient access to treatment or compromise optimal outcomes.

• Inform accounts about the BOTOX treatment process, suitable reimbursement practices, and the payer landscape.

• Recognize access and reimbursement obstacles while providing actionable insights and tailored solutions.

• Investigate root causes of access challenges.

• Keep regional and national payers updated on medical policies, prior authorization prerequisites, and product acquisition.

• Share critical information through compliant communication methods.

• Collaborate with Market Access, Center of Excellence, Sales, Marketing, Training, Compliance, Trade, Specialty Pharmacy, and senior leadership teams.

• Provide feedback from customers regarding approval requirements and barriers to accessing care.

• Educate accounts about HUB services, patient savings programs, payer coverage specifics, and acquisition pull-through strategies.

• Build and nurture relationships with healthcare professionals, staff, and business decision-makers, including C-suite executives.

• Lead without direct authority, effectively communicate across diverse groups, influence various functions, and achieve consensus on patient solutions.

• Conduct significant conversations in a professional manner.

• Participate in Field Input Teams and propose innovative solutions in a dynamic environment.

• Share customer challenges and possible solutions.

• Organize, prioritize, follow up, and foresee potential issues.

• Ensure all tasks comply with AbbVie standards and relevant regulations.

⛳️ Requirements

• At least 5–7 years of demonstrated success in a healthcare-related field.

• A bachelor's degree is mandatory.

• Experience in Sales, District Management, Hospital, Managed Markets, Access and Reimbursement, or practice settings is preferred.

• Familiarity with Lean Six Sigma principles is advantageous.

• Knowledge of physician-administered injectables, CPT and/or J-code reimbursement, Specialty Pharmacy and Buy & Bill acquisition, Benefit Verifications, Prior Authorizations, Claim Assistance, Appeals, payer policies, and HUB services.

• A proven track record of working comprehensively with accounts at all levels.

• Experience with payer/insurance coverage for Medicare, Medicare Advantage, Commercial, and Medicaid plans.

• Strong verbal and written communication abilities, including skills for presenting complex information and processes both in-person and virtually.

• Demonstrated expertise in Problem Solving, Gaining Access, Resource Mastery, Achieving Tangible Results, Overcoming Adversity, Collaboration, and Managing Complexities.

• Attributes such as Empathy, Critical Thinking, Curiosity, Persistence, Reliability, and Resourcefulness are essential.

• A solid history of leadership in the current role.

• Proficiency in technology and analytical skills, including Salesforce, virtual meetings, Excel, and report interpretation.

• A valid driver’s license is required.

• Willingness to travel adequately to cover the territory, attend training sessions, and participate in meetings; some overnight travel may be necessary.

• Candidates should reside within a reasonable distance from the primary city.

• Ability to operate across the two-state region of MN and ND.

🏝️ Benefits

• Paid time off including vacation, holidays, and sick leave.

• Comprehensive medical, dental, and vision insurance.

• 401(k) retirement savings plan.

• Eligibility for long-term incentive programs.

• Option for remote work.

• Equal opportunity employer dedicated to integrity, innovation, transforming lives, and community service.