Field Reimbursement Manager – Botox Therapeutic

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

📋 Description

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

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

• Provide education on the fundamentals of BOTOX treatment, reimbursement processes, and the payer landscape.

• Recognize access and reimbursement obstacles and offer actionable insights and approved care solutions.

• Investigate the underlying causes of access issues.

• Monitor and report on updates from regional and national payers, including changes in medical policy, prior authorization, and product acquisition.

• Share critical information using compliant communication methods.

• Collaborate with stakeholders from Market Access, Center of Excellence, Sales, Marketing, Training, Compliance, Trade, and Specialty Pharmacy.

• Gather customer feedback regarding approval requirements and access-to-care challenges.

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

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

• Lead without formal authority, communicate effectively with diverse groups, and influence across functions to achieve consensus.

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

• Plan, prioritize, follow up, and proactively address potential issues.

• Conduct all activities in compliance with AbbVie and relevant regulatory requirements.

⛳️ Requirements

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

• Bachelor’s degree is required.

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

• Familiarity with 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, Claim Assistance, Appeals, payer policies, and HUB services.

• Proven track record of comprehensive engagement with accounts at all levels.

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

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

• Capable of problem-solving, gaining access, mastering resources, achieving tangible results, overcoming challenges, collaborating, and managing complexities.

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

• Strong history of leadership in the current role.

• Proficient technology and analytical skills, including Salesforce, virtual meeting platforms, Excel, and report interpretation.

• Valid driver's license and ability to meet safe driving standards.

• Ability to pass a pre-employment drug screening test.

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

🏝️ Benefits

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

• Comprehensive medical, dental, and vision insurance.

• 401(k) retirement plan.

• Long-term incentive programs.

• Option for a company car or truck.

• Extensive benefits package.