Field Reimbursement Manager - Little Rock, AK

Amgen•Little Rock, AR

10d•$145,471 - $196,813•Remote

About The Position

The Field Reimbursement Manager (FRM) manages defined accounts within a specified geographic region for Patient Access and Reimbursement, supporting Amgen’s Bone Health business unit and executing the collaborative territory strategic plan. The FRM helps healthcare providers understand reimbursement processes, field reimbursement services, and patient support programs, and resolves patient-level reimbursement issues involving protected health information. The territory covers Arkansas; relocation is not included. The FRM acts as an extension of the HUB and provides live, one-on-one coverage support throughout the reimbursement journey, from physician order through payer prior authorization, appeals, denials, and claims resolution. The role educates healthcare providers about public and private payer coverage, benefit design, and access changes; reviews requested patient-specific coverage challenges and insurance benefit options; coordinates issues with the HUB and other partners; and educates offices using approved materials. The position is remote/work from home with customer appointments in the geography two days per week and one to two home-office days per week. Travel of up to 40% by automobile or plane is required. The role may involve prolonged sitting and keyboard work, and requires a valid driver’s license with a clean driving record.

Requirements

Meet one of the following education and experience combinations: doctorate degree; master’s degree and 3 years of customer service and/or leadership experience; bachelor’s degree and 5 years of customer service and/or leadership experience; associate degree and 10 years of customer service and/or leadership experience; or high school diploma/GED and 12 years of customer service and/or leadership experience.
Have experience directly managing people and/or leadership experience leading teams, projects, or programs, or directing resource allocation. This experience may run concurrently with the other required experience.
At least 2 years of experience in a public or private third-party access arena or pharmaceutical industry in managed care, clinical support, and/or sales.
Strong medical reimbursement experience and/or knowledge of Specialty Pharmacy and Buy & Bill.
Proven presentation and facilitation skills.
Strong written and oral communication skills.
Organizational and project management skills, including the ability to manage multiple projects.
Computer literacy, including Word, Excel, PowerPoint, and web-based meetings.
Healthcare industry experience, including insurance verification, claim adjudication, physician offices or clinics, pharmacies, and/or pharmaceutical manufacturers.
Experience with HUBs and in-depth knowledge of billing, coding, and appeals issues across physician types.
Ability to collaborate and lead cross-functional partner meetings.
Experience with commercial payers, Medicare plans, and state Medicaid in a geographic region.
Live in the geography or within 10 miles of its border.
Valid driver’s license with a clean driving record.
Ability to travel up to 40% by automobile or plane.

Nice To Haves

Bachelor’s degree in business, healthcare, or a related field.
6 years of experience with specialty/biologic self-injectable products (pharmacy benefit) or physician-administered products (Buy & Bill/medical benefit).
Advanced knowledge of medical insurance terminology.
Knowledge of Centers for Medicare & Medicaid Services (CMS) policies and processes, with expertise in Medicare Part B for Buy & Bill products and Part D for pharmacy products.
Ability to manage ambiguity and problem-solve.
Ability to manage expenses within allocated budgets.
Strong medical reimbursement experience and/or knowledge of Specialty Pharmacy and Buy & Bill.
Proven presentation and facilitation skills.
Strong written and oral communication skills.
Organizational and project management experience, including the ability to manage multiple projects.
Computer literacy, including Word, Excel, PowerPoint, and web-based meetings.
Healthcare industry experience, including insurance verification, claim adjudication, physician offices or clinics, pharmacies, and/or pharmaceutical manufacturers.

Responsibilities

Manage defined accounts within a specified geographic region for Patient Access and Reimbursement.
Execute the collaborative territory strategic plan in support of products.
Act as an extension of the HUB, providing live one-on-one coverage support.
Support the reimbursement journey from physician order through prior authorization, appeals, denials, and claims resolution.
Review patient-specific information when a site requests assistance with reimbursement issues or coverage challenges.
Educate and update healthcare providers on private and public payer coverage and changes that affect patient access.
Coordinate access and reimbursement issues with relevant partners, including the HUB.
Explain product coverage under commercial, Medicare, and Medicaid benefit designs.
Serve as the payer expert for the defined geography and promptly communicate payer changes to stakeholders.
Provide office education on formulary coverage and utilization management criteria, insurance forms and procedures, benefits investigation, prior authorization, appeals, and claims resolution.
Educate offices using approved materials.
Review patient insurance benefit options and alternate funding or financial assistance programs.
Collaborate with other departments to resolve reimbursement issues.

Benefits

Retirement and Savings Plan with generous company contributions.
Group medical coverage.
Dental coverage.
Vision coverage.
Life insurance.
Disability insurance.
Flexible spending accounts.
Discretionary annual bonus program or, for field sales representatives, a sales-based incentive plan.
Stock-based long-term incentives.
Award-winning time-off plans.
Flexible work models where possible.
Career development opportunities.
Work/life balance support.