Field Reimbursement Manager - West
About The Position
The Field Reimbursement Manager (FRM) is a key contributor to the patient support program for Purified Cortrophin Gel. The FRM serves as a partner in product access, focusing on patient support, access, reimbursement, prior authorization, appeals, financial assistance, and related business issues within the patient support division. The role involves communicating with the case management team conducting benefit investigations, educating healthcare providers on prior authorization and appeal processes, and coordinating other patient services. The position is remote and covers the Pacific and Mountain West territory: WA, OR, CA, AZ, NV, UT, ID, MT, WY, CO, NM, KS, OK, NE, SD, ND, MN, and MO.
Requirements
- Relevant post-secondary education or applicable certifications.
- Minimum 3–4 years of experience working with specialty medications in pharmaceutical companies, provider offices, or with insurance payers.
- Demonstrated expertise with both pharmacy and medical benefits in a specialty disease market.
- Familiarity with OIG guidance, HIPAA guidelines, and FDA protocols.
- Strong collaboration with Hub partners and cross-functional colleagues.
- A sense of urgency in addressing critical patient access issues.
- Problem-solving ability to navigate challenging access scenarios and identify solutions.
- Initiative to move patient cases forward.
- Strong interpersonal and communication skills.
- Ability to travel up to 25%, with some evening and weekend commitments.
Responsibilities
- Provide proactive education to healthcare providers about insurance requirements for patients’ prescriptions.
- Work with Hub case managers and in-network specialty pharmacies on prior authorization requirements and communication with healthcare providers and patients.
- Coordinate communication and activities with Nurse Access Specialist colleagues.
- Facilitate patient assistance when applicable, including copay and free-goods assistance.
- Partner with managed care colleagues to understand policies and highlight new trends.
- Collaborate with sales colleagues when appropriate and as directed by Compliance policies.
- Receive development and mentoring from a director on the field reimbursement team.
Benefits
- Health insurance coverage
- Life and disability insurance
- Retirement savings plans
- Paid leave programs
- Paid holidays
- Paid time off
- Short-term and long-term incentive program based on performance and company results
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
