Field Reimbursement Manager – Rockies

This is a fully remote position, open to applicants in Colorado, +2 more states.

📋 Description

• Act as the subject matter expert on reimbursement, access, and coverage matters for products, mainly in Nephrology and potentially in other therapeutic areas.

• Serve as a link between healthcare providers, internal teams, and external stakeholders to enhance patient access to products.

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

• Evaluate payer criteria and offer product access expertise to healthcare offices.

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

• Work in conjunction with Field Sales, Specialty Pharmacy Accounts, and other matrix partners.

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

• Implement collaborative territory plans through internal and external partnerships.

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

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

• Aid in resolving patient-specific coverage issues when requested by healthcare providers.

⛳️ Requirements

• A Bachelor's degree is required.

• At least 5 years of experience in the pharmaceutical industry, with a preference for a focus on payer policy and reimbursement.

• A minimum of 3 years of experience in benefit verifications, prior authorizations, or comparable experience in patient access, billing, and coding in rare diseases is preferred.

• Strong understanding of Centers for Medicare & Medicaid Services (CMS) policies and processes, particularly Medicare Part D.

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

• Experience in Nephrology is strongly preferred.

• Thorough comprehension of US healthcare system payer billing practices.

• Proficient in the MS Office suite.

• Excellent verbal and written communication skills.

• Strong interpersonal and consultative skills.

• Self-motivated with exceptional organizational abilities.

• Capability to build and maintain robust relationships with both internal and external customers.

• Skilled in delivering training and presentations.

• 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.

• Paid holidays.

• Paid leave programs.

• Additional company-provided benefits.

• Incentive opportunities.