Field Reimbursement Manager – Mid Atlantic

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

📋 Description

• Act as the subject matter expert on reimbursement, access, and coverage matters for products, mainly in Nephrology and Rare Disease.

• Serve as a bridge between healthcare professionals, internal teams, and external stakeholders to enhance patient access.

• Provide education to healthcare providers and their staff regarding access, coverage, reimbursement processes, claims submissions, and coding requirements.

• Assess payer criteria and offer product access insights to healthcare facilities.

• Collaborate with Hubs on individual patient cases, including patient support services and enrollment.

• Work alongside Field Sales, Specialty Pharmacy Accounts, and other matrix partners.

• Oversee daily field operations, dedicating 60-70% of time to engaging with key stakeholders across various care sites.

• Implement collaborative territory strategies with both internal and external stakeholders.

• Review and inform offices about payer policies, including requirements for prior authorization.

• Relay feedback to internal teams regarding local payer trends and access challenges.

• Assist healthcare providers in tackling patient-specific coverage issues as needed.

⛳️ Requirements

• Bachelor’s degree.

• Over 5 years of experience in the pharmaceutical industry, focusing on payer policy and reimbursement.

• More than 3 years of experience in benefit verifications, prior authorization requirements, or comparable experience in patient access, billing, and coding within rare disease.

• Exceptional verbal and written communication abilities.

• Strong interpersonal and consultative skills.

• Highly self-motivated with excellent organizational capabilities.

• Capacity to establish and maintain robust relationships with both internal and external clients.

• Skilled in delivering training and presentations.

• In-depth knowledge of Centers for Medicare & Medicaid Services (CMS) policies and procedures, particularly Medicare Part D.

• Experience in a "Buy and Bill" reimbursement environment.

• Nephrology experience is strongly preferred.

• Thorough understanding of US healthcare system payer billing practices.

• Proficient in the MS Office suite.

• Willingness to travel domestically up to 60-70% of the time.

• A valid driver's license is required.

🏝️ Benefits

• Comprehensive medical, dental, vision, and prescription drug coverage.

• Basic life insurance provided by the company.

• Accidental death and dismemberment insurance.

• Short-term and long-term disability insurance.

• Tuition reimbursement.

• Assistance with student loans.

• Generous 401(k) matching program.

• Flexible time off policy.

• Paid holidays.

• Paid leave programs.

• Additional benefits provided by the company.

• Opportunity for incentives.