Field Reimbursement Manager (FRM) - Greater NY

Otsuka Pharmaceutical Co., Ltd. • New York, NY

42d • $134,615 - $201,250 • Remote

About The Position

The Field Reimbursement Manager (FRM) serves as the subject-matter expert on reimbursement, access, and coverage issues for our products, primarily focusing on Nephrology and Rare Disease. This role operates as a crucial liaison between healthcare providers (HCPs), internal teams, and external stakeholders to facilitate appropriate patient access to our products.

Requirements

• Bachelor's degree
• 5+ years of pharmaceutical industry experience, with focus on payer policy and reimbursement
• 3+ years of experience in benefit verifications, prior-authorization requirements, or equivalent experience in patient access, billing, and coding in rare disease
• Ability to travel up to 60-70% domestically
• Valid driver's license required

Nice To Haves

• Strong knowledge of Centers for Medicare & Medicaid Services (CMS) policies and processes, especially Medicare Part D
• Experience in "Buy and Bill" reimbursement environment
• Nephrology experience strongly preferred
• Comprehensive understanding of US healthcare system payer billing practices
• Proficiency in MS Office suite

Responsibilities

• Educate HCPs and their staff on matters related to access, coverage, reimbursement processes, claims submissions, and coding requirements
• Analyze payer criteria and provide product access expertise to healthcare offices
• Coordinate with Hubs on individual patient cases, 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 through partnerships with internal and external stakeholders
• Review and educate offices on payer policies, including prior authorization requirements
• Provide feedback to internal teams on local payer trends and access issues
• Assist in resolving patient-specific coverage challenges when requested by healthcare providers

Benefits

• Comprehensive medical, dental, vision, prescription drug coverage
• Company provided basic life, accidental death & dismemberment, short-term and long-term disability insurance
• Tuition reimbursement
• Student loan assistance
• A generous 401(k) match
• Flexible time off
• Paid holidays
• Paid leave programs

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level