Field Reimbursement Manager - Hartford, CT

Amgen • Bridgeport, CT

1d • Remote

About The Position

The Field Reimbursement Manager (FRM) manages defined accounts within a specified geographic region for Patient Access and Reimbursement and supports the Bone Health business unit. The FRM executes the collaborative territory strategic plan and helps healthcare providers understand reimbursement processes, field reimbursement services, and patient support programs. The role includes resolving patient-level reimbursement issues and working with patient health information when a site specifically requests assistance. The territory covers Central and Western Massachusetts and Western, Central, and Southern Connecticut. 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 orders through payer prior authorization, appeals, denials, and claims resolution. The role educates healthcare providers about public and private payer coverage, benefit design, formulary coverage, utilization management, insurance procedures, benefits investigations, and financial assistance options. The FRM coordinates with the HUB and other partners and serves as a payer expert for the assigned geography.

This is a remote, work-from-home position involving 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. Work may involve general office demands, prolonged sitting, and keyboard work. A valid driver’s license and clean driving record are required.

Amgen offers a competitive benefits package, retirement and savings plan with company contributions, medical, dental and vision coverage, life and disability insurance, flexible spending accounts, a discretionary annual bonus program or field sales incentive plan, stock-based long-term incentives, time-off plans, flexible work models where possible, and career development opportunities. The posted annual salary range is $145,470.70–$196,813.30, with actual salary varying based on relevant skills, experience, and qualifications.

Requirements

• Doctorate degree; OR master’s degree and 3 years of customer service and/or leadership experience; OR bachelor’s degree and 5 years of customer service and/or leadership experience; OR 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.
• Experience directly managing people and/or leadership experience leading teams, projects, or programs, or directing resource allocation.
• At least 2 years of experience in a public or private third-party access arena or the pharmaceutical industry in managed care, clinical support, and/or sales.
• Strong medical reimbursement experience and/or Specialty Pharmacy and Buy & Bill knowledge.
• Proven presentation and facilitation skills.
• Strong written and oral communication skills.
• Organizational skills and project management experience, including the ability to manage multiple projects.
• Computer literacy, including Word, Excel, and PowerPoint, and ability to conduct 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.
• Strong collaboration skills and ability to 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 Specialty Pharmacy and Buy & Bill knowledge.
• Proven presentation and facilitation skills.
• Strong written and oral communication skills.
• Organizational skills and project management experience, including the ability to manage multiple projects.
• Computer literacy, including Word, Excel, and PowerPoint, and ability to conduct 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.
• Support products by executing the collaborative territory strategic plan.
• Ensure understanding of reimbursement processes, field reimbursement services, and patient support programs.
• Resolve patient-level reimbursement issues, using patient health information when assistance is specifically requested by a site.
• Act as an extension of the HUB and provide live, one-on-one coverage support.
• Assist healthcare providers from physician order through reimbursement, including payer prior authorization, appeals, denials, and related requirements and forms.
• Review patient-specific information to help resolve access issues or coverage challenges when requested by a site.
• 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 a payer expert for the assigned geography and promptly communicate payer changes to stakeholders.
• Educate offices on formulary coverage, utilization management criteria, insurance forms and procedures, benefits investigations, 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.
• Attend customer appointments in the geography two days per week and work from a home office one to two days per week.
• Travel up to 40% by automobile or plane.

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

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED