Field Reimbursement Manager

AbbVie•Kansas City, KS

15h•Onsite

About The Position

The Field Reimbursement Manager (FRM) is a field-based, alternative in-office resource who addresses health care provider (HCP) questions about patient access. The FRM calls directly on HCP offices within an assigned geography to provide support for AbbVie’s Vraylar product. This role provides expertise on coverage and common access and reimbursement challenges, educates HCPs about AbbVie access and reimbursement support tools, advises on patient prescription status and program eligibility, and explains payer processes and procedures. Candidates should live within a reasonable distance of the primary city. The hiring level will be commensurate with experience. The role requires knowledge of managed care, reimbursement, payer policies, coding and billing, Medicare reimbursement, and specialty medicine acquisition and dispensing. The FRM establishes and maintains relationships with providers in the territory, shares payer trends with internal teams, and interacts compliantly with reimbursement support services. The position involves driving a personal or company vehicle and meeting applicable health care industry representative credentialing requirements for access to facilities and organizations in the assigned territory.

Requirements

At least 3 years of experience in the specific therapeutic area, with experience in Managed Health Care, Payer Account Management, and/or Access and Reimbursement.
Excellent territory and account management skills.
Extensive experience educating others about payer processes, coverage requirements, and other access-related situations for specialty medicines.
Strong track record of leadership in the current role.
Strong understanding of, and ability to communicate, technical coding and billing requirements at national and regional levels across all care settings.
Comprehensive understanding of Medicare Parts A, B, C, and D and associated reimbursement dynamics.
Strong understanding of drug acquisition and dispensing in the relevant therapeutic area, including specialty pharmacies, specialty distributors, and white-bagging.
Demonstrated understanding of the rules, regulations, and risks associated with providing reimbursement support services.
Strong understanding of access and reimbursement support service centers and how to interact with them compliantly.
Valid driver’s license; ability to pass a pre-employment drug screening and meet safe driving requirements.
Ability to drive a personal or company auto or truck, or a powered piece of material handling equipment.
Ability to satisfy and maintain applicable health care industry representative credentialing requirements for facilities and organizations in the assigned territory, and to be in good standing or eligible to obtain the credentials. Requirements may include background checks, drug screens, immunization or vaccination proof, fingerprinting, and licenses required by particular states or cities.

Nice To Haves

Bachelor’s degree in health, sciences, pharmacy, or a business-related field.

Responsibilities

Educate HCPs on patient support programs, including access and reimbursement support tools and services.
Educate HCPs on product-specific acquisition and access options, including specialty pharmacy networks and specialty distribution.
Educate HCPs on resources available to address access issues.
Provide local expertise on national and regional payer policies, including payer issues, coding changes, and appropriate claims submission processes.
Liaise with AbbVie’s Access and Reimbursement support center to update HCPs on prescription status and program eligibility.
Report payer trends related to approved products to Patient Services and MHC account management teams.
Establish and maintain relationships with appropriate providers within the assigned territory.
Remain current on key managed care, reimbursement, and policy activities.