Senior Field Reimbursement Manager – HIV Prevention

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

📋 Description

• Cultivate and oversee strategic business relationships with key account stakeholders within large health systems, Integrated Delivery Networks (IDNs), specialty pharmacies, national and regional accounts, as well as Priority/SWAT accounts to enhance patient access to Gilead’s HIV Prevention products.

• Act as a reimbursement and access authority at the enterprise level, utilizing influence mapping to pinpoint stakeholders within intricate organizational structures.

• Spearhead coordinated account strategies across regions to minimize redundancy, clarify roles, and ensure consistent customer support throughout multi-site accounts.

• Evaluate systemic access and reimbursement challenges, including benefit verification, prior authorization, medical exceptions, claims processes, acquisition methods, specialty pharmacy operations, and long-acting injection workflows.

• Collaborate with senior account stakeholders and internal matrix teams to create, refine, and support scalable reimbursement processes.

• Assist the internal patient support program team in improving HUB and Field Reimbursement Manager (FRM) processes, including training on prior authorizations, benefit verification, case management transitions, and account-specific workflow enhancements.

• Relay changes in formulary, coverage, payer policies, and reimbursement processes, providing strategic accounts with timely education and support.

• Develop and implement instructional materials, account implementation strategies, and best-practice training for providers, office personnel, billing teams, revenue cycle teams, and implementation stakeholders.

• Coordinate efforts among FRMs, Long-Acting Implementation Directors, Strategic Account Managers, Prevention Specialists, Market Access teams, the Gilead HUB, Marketing, Patient Support, and other cross-functional collaborators.

• Identify bottlenecks in patient journeys and leverage technological tools, insights, and escalation pathways to address high-need account circumstances.

• Evaluate success through the effectiveness of educational delivery, implementation success rates, resolution of systemic issues, improved coordination, and scalable access/reimbursement support.

• Exhibit cultural sensitivity and customize support to fit diverse account environments and practices.

• Uphold a patient-centered, collaborative approach centered on enhancing access and achieving positive outcomes.

⛳️ Requirements

• Bachelor’s Degree with eight years of experience, or a Master’s Degree with six years of experience, or a Ph.D.

• BA/BS/RN with over eight years of experience in a major pharmaceutical organization focused on field reimbursement, access, patient services, market access, account management, or a similar team.

• MA/MS/PharmD with a minimum of six years of experience in a major pharmaceutical organization within field reimbursement, access, patient services, market access, account management, or a related role.

• Prior experience in leadership, enterprise accounts, IDN/health systems, or cross-functional account strategies is highly desirable.

• Comprehensive understanding of the interactions between payers, providers, health systems, specialty pharmacies, and pharmaceutical companies regarding reimbursement and access.

• Proven experience in engaging and managing large, complex provider accounts, multi-location health systems, IDNs, national/regional accounts, and/or accounts that cover multiple states or regions.

• Familiarity with pharmacy benefits, medical benefits, specialty payer landscapes, reimbursement pathways, and acquisition models across commercial, Medicare, Medicaid, and other payer segments.

• Awareness of local, state, and national policy changes and their impacts on reimbursement, coverage, acquisition, and account workflows.

• Experience collaborating with specialty pharmacies and HUB services to enhance account-specific workflow optimization and patient access processes.

• Skill in influencing without direct authority, aligning matrixed stakeholders, and converting account-level barriers into scalable process enhancements.

• Strong executive presence with the ability to engage C-suite or executive leadership, pharmacy directors, revenue cycle leaders, implementation leaders, and system stakeholders.

• Willingness to travel 75% of the time across designated regions and strategic accounts.

• Candidates must reside in or near the designated geography and be capable of extensive travel to meet with account stakeholders in person.

🏝️ Benefits

• Discretionary annual bonus.

• Discretionary stock-based long-term incentives.

• Paid time off.

• Company-sponsored medical insurance.

• Company-sponsored dental insurance.

• Company-sponsored vision insurance.

• Company-sponsored life insurance.