Field Reimbursement Manager – Botox Therapeutic

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

📋 Description

• Educate healthcare providers and their staff regarding Medical and Pharmacy benefits, Buy & Bill processes, Specialty Pharmacy acquisition, payer policies, patient identification, clinical documentation, benefit investigations, prior authorizations, billing, coding, patient tracking, claims management, reconciliation, savings programs, retreatment, and denial/appeal processes for approved BOTOX Therapeutics indications.

• Identify and clarify obstacles that hinder appropriate patient access and optimal outcomes.

• Engage with healthcare providers, administrative personnel, revenue cycle management, and institutional leadership.

• Instruct accounts on the BOTOX treatment procedure, reimbursement strategies, payer landscape, HUB services, patient savings initiatives, coverage specifics, and acquisition efforts.

• Analyze the root causes of access issues and offer tailored, actionable solutions.

• Keep stakeholders informed about regional and national payer changes and barriers.

• Share essential information using compliant communication methods.

• Serve as a liaison among Market Access, Center of Excellence, Sales, Marketing, Training, Compliance, Trade, and Specialty Pharmacy teams.

• Provide customer insights regarding approval requirements and access challenges.

• Build and sustain relationships with healthcare professionals, staff, and C-suite decision makers.

• Lead without direct authority, influence cross-functional teams, facilitate consensus, and engage in crucial conversations.

• Participate in Field Input Teams and suggest solutions to customer challenges.

• Plan, prioritize tasks, follow up, anticipate potential issues, and adhere to AbbVie and regulatory standards.

⛳️ Requirements

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

• A Bachelor’s degree is mandatory.

• Preferred experience includes Sales, District Management, Hospital settings, Managed Markets, Access and Reimbursement, or practice environments.

• Knowledge of Lean Six Sigma principles is advantageous.

• Experience with physician-administered injectables, CPT and/or J-code reimbursement, Specialty Pharmacy and Buy & Bill acquisition, Benefit Verifications, Prior Authorizations, Claims Assistance, Appeals, payor policies, and HUB services.

• Proven experience working with accounts at various levels.

• Familiarity with payer/insurance coverage, including Medicare, Medicare Advantage, Commercial, and Medicaid plans.

• Excellent verbal and written communication skills, including proficiency in in-person and virtual presentations.

• Skills in problem-solving, gaining access, resource mastery, achieving tangible results, overcoming challenges, collaboration, and managing complexities.

• Traits such as empathy, critical thinking, curiosity, persistence, reliability, and resourcefulness.

• Strong leadership track record.

• Proficiency in technology and analytical tools, including Salesforce, virtual meeting platforms, Excel, and report interpretation.

• Capability to operate a personal vehicle, company car or truck, or powered material-handling equipment.

• A valid driver’s license is required.

• Must pass a pre-employment drug screening and meet safe driving criteria.

• Willingness to travel as needed to cover territory, attend training sessions, and meetings; some overnight travel may be necessary.

🏝️ Benefits

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

• Comprehensive medical, dental, and vision insurance.

• 401(k) retirement plan.

• Long-term incentive programs.

• Option for remote work.

• Opportunities for travel and training.