Field Reimbursement Manager- Washington D.C.

Amgen • Washington, DC

4d • $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 products by executing a 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 (PHI). The territory covers Washington, D.C., and Baltimore, Maryland; 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 on payer coverage and changes, benefit design, formulary criteria, utilization management, insurance procedures, benefit investigations, and available financial assistance options. The FRM reviews patient-specific information when requested by a site, coordinates access issues with the HUB and other partners, serves as a payer expert for the geography, and collaborates across departments to resolve reimbursement challenges.

The position is remote and work-from-home, with two days per week in the geography for customer appointments and one to two home-office days per week. Travel of up to 40% by automobile or plane is required. The role may involve long periods of sitting and keyboard work.

Amgen offers a Total Rewards Plan, subject to eligibility, with health and welfare plans, financial plans, work/life balance support, and career development opportunities. The expected annual salary range is $145,470.70–$196,813.30. Actual salary depends on relevant skills, experience, and qualifications.

Requirements

• Meet one of the following education and experience combinations: doctorate degree; master's degree plus 3 years of customer service and/or leadership experience; bachelor's degree plus 5 years of customer service and/or leadership experience; associate's degree plus 10 years of customer service and/or leadership experience; or high school diploma/GED plus 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 required technical 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 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.
• Strong 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.
• Proven 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.
• Must have a valid driver's license with a clean driving record.
• Must be able 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 (pharmacy benefit) or physician-administered (buy and bill/medical benefit) products.
• 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-and-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.
• Strong 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.
• Execute the collaborative territory strategic plan in support of products.
• Act as an extension of the HUB by providing 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 when a site requests help resolving issues or coverage challenges.
• Educate and update healthcare providers on private and public payer coverage and changes affecting 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 defined geography and communicate payer changes promptly to stakeholders.
• Provide office education on formulary coverage, utilization management criteria, insurance forms and procedures, benefit investigations, prior authorization, appeals, and claims resolution.
• Educate healthcare provider 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 a sales-based incentive plan for field sales representatives.
• Stock-based long-term incentives.
• Award-winning time-off plans.
• Work/life balance support.
• Career development opportunities.
• Flexible work models where possible.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed