Field Reimbursement Manager (FRM) - Rockies

Otsuka Pharmaceutical Co., Ltd.•Salt Lake City, UT

19h•$150,034 - $224,250

About The Position

The Field Reimbursement Manager (FRM) serves as a subject-matter expert on reimbursement, access, and coverage issues for Otsuka products, primarily in Nephrology and potentially in other therapeutic areas. The role acts as a liaison between healthcare providers, internal teams, and external stakeholders to facilitate appropriate patient access to products. The position is field-based, with 60–70% of time spent interacting with stakeholders at various care sites, and requires up to 60–70% domestic travel.

Requirements

Bachelor's degree required.
Minimum of 5 years of pharmaceutical industry experience; payer policy and reimbursement focus is preferred.
Strong knowledge of Centers for Medicare & Medicaid Services (CMS) policies and processes, especially Medicare Part D.
Experience in a Buy and Bill reimbursement environment.
Comprehensive understanding of U.S. healthcare system payer billing practices.
Proficiency in the MS Office suite.
Excellent verbal and written communication skills.
Strong interpersonal and consultative abilities.
Self-directed, with outstanding organizational skills.
Ability to build and maintain strong relationships with internal and external customers.
Proficiency in delivering training and presentations.
Ability to travel domestically up to 60–70%.
Valid driver's license required.

Nice To Haves

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

Responsibilities

Educate healthcare providers and their staff about access, coverage, reimbursement processes, claims submissions, and coding requirements.
Analyze payer criteria and provide product access expertise to healthcare offices.
Coordinate individual patient cases with Hubs, including patient support services and enrollment.
Collaborate with Field Sales, Specialty Pharmacy Accounts, and other matrix partners.
Manage daily field-based activities, spending 60–70% of time interacting with key stakeholders across various care sites.
Execute collaborative territory plans with internal and external stakeholders.
Review and educate offices on payer policies, including prior authorization requirements.
Provide internal teams with feedback on local payer trends and access issues.
Assist with resolving patient-specific coverage challenges when requested by healthcare providers.