Field Reimbursement Manager

ExecuSearch of Chicago,
Onsite

About The Position

The Field Reimbursement Manager (FRM) is a critical field-based role responsible for removing access and reimbursement barriers so patients can start and stay on therapy without unnecessary delay. The FRM partners directly with healthcare providers, specialty pharmacies, hospital systems, and internal stakeholders to navigate complex payer environments and deliver a seamless patient access experience. This role requires deep expertise in pharmacy benefit design, prior authorizations, appeals, specialty pharmacy operations, and government and commercial payer landscapes. The ideal candidate is proactive, highly credible with providers, and relentless about solving complex access challenges that stand between patients and life-altering therapies. This individual operates with autonomy, urgency, and strong cross-functional collaboration while serving as a strategic voice of the field to internal teams.

Requirements

  • Bachelor’s degree with 5+ years of experience in reimbursement, patient access, field access, or specialty pharmacy roles within biotech, specialty pharma, or rare disease environments.
  • Deep knowledge of commercial and government pharmacy benefits, including Medicare Part D, Medicaid, specialty pharmacy operations, prior authorizations, appeals, and limited distribution models.
  • Experience supporting neurology or CNS-focused practices preferred, including familiarity with hospital systems and complex site-of-care coordination.
  • Demonstrated success supporting specialty product launches and independently managing complex reimbursement and coverage challenges within a field-based territory.
  • Strong analytical, problem-solving, and relationship-building skills, with the ability to influence cross-functional stakeholders and identify systemic access barriers.
  • Operates with urgency, ownership, sound judgment, and a high-integrity compliance mindset in a fast-paced field environment.
  • Exceptional communication skills with the ability to establish credibility with physicians, office leadership, specialty pharmacies, and internal partners.

Nice To Haves

  • Experience supporting neurology or CNS-focused practices preferred, including familiarity with hospital systems and complex site-of-care coordination.

Responsibilities

  • Serve as the reimbursement and access lead for the assigned territory, partnering with provider offices, hospitals, specialty pharmacies, and internal teams to remove barriers to therapy initiation and continuation.
  • Educate healthcare providers and office staff on payer coverage requirements, prior authorization and appeals processes, specialty pharmacy workflows, documentation standards, and reimbursement pathways across commercial and government pharmacy benefits.
  • Proactively manage complex patient access scenarios by coordinating across specialty pharmacies, case managers, hospital systems, and payer stakeholders to resolve onboarding, coverage, and continuity-of-care challenges.
  • Build trusted relationships with neurologists, practice administrators, and institutional stakeholders to identify emerging access issues, develop territory-specific solutions, and support patients through evolving coverage landscapes.
  • Serve as a strategic field partner to Market Access, Patient Services, and Commercial leadership by providing payer insights, competitive intelligence, reimbursement trends, and real-time field feedback that inform broader access strategy and launch execution.
  • Apply deep expertise across pharmacy benefit design, specialty distribution, inpatient access coordination, medical benefit reimbursement where applicable, and payer policy interpretation to independently navigate novel or highly complex reimbursement scenarios.
  • Maintain compliant and accurate documentation of field activities, account insights, and patient access trends within CRM and patient services systems while ensuring all activities align with company policies, regulatory requirements, and payer guidelines.
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