Field Reimbursement Manager – South East

This is a fully remote position, open to applicants in Alabama, +1 more state.

📋 Description

• Serve as the expert on reimbursement, access, and coverage matters for Nephrology and Rare Disease products.

• Function as a liaison among healthcare providers, internal teams, and external stakeholders to ensure appropriate patient access.

• Educate healthcare providers and staff regarding access, coverage, reimbursement processes, claims submissions, and coding requirements.

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

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

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

• Oversee daily field-based activities, dedicating 60-70% of time to interactions with stakeholders across care sites.

• Implement collaborative territory plans.

• Review and educate offices on payer policies and prior authorization requirements.

• Provide internal teams with insights on local payer trends and access challenges.

• Assist healthcare providers with 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.

• At least 3 years of experience in benefit verifications, prior authorization requirements, or equivalent experience in patient access, billing, and coding in rare diseases.

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

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

• Nephrology experience is highly preferred.

• Comprehensive knowledge of US healthcare system payer billing practices.

• Proficiency in the MS Office suite.

• Exceptional verbal and written communication abilities.

• Strong interpersonal and consultative skills.

• Self-motivated with excellent organizational capabilities.

• Ability to foster and maintain strong relationships with internal and external clients.

• 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.

• Company-provided basic life insurance.

• Accidental death & dismemberment insurance.

• Short-term and long-term disability insurance.

• Tuition reimbursement.

• Student loan assistance.

• Generous 401(k) matching.

• Flexible time off.

• Paid holidays.

• Paid leave programs.

• Incentive opportunities.