Field Reimbursement Specialist Senior Manager - West - Los Angeles CA

Military Spouse Corporate Career Network•Los Angeles, CA

4d•Onsite

About The Position

The Tezspire Field Reimbursement Regional Senior Manager leads a regional team of Field Reimbursement Managers and executes reimbursement strategy to support optimal access to Tezspire within the Respiratory therapeutic area. The role builds and coaches a high-performing team, translates national and regional priorities into effective field execution, and fosters accountability, collaboration, inclusion, and positive momentum. The Senior Manager is accountable for team performance against field KPIs and service expectations, including field-time measures, while ensuring an excellent and compliant access experience for customers and patients. The position uses payer, account, market, competitive, channel, and performance insights to guide regional strategy, develop team capabilities, and proactively address access barriers across Specialty Pharmacy and Buy & Bill channels. It leads regional planning, business reviews, cross-functional collaboration, compliance, and operational execution, while hiring, developing, and retaining talent.

Requirements

One of the following: doctorate degree and 2 years of relevant experience; master's degree and 4 years; bachelor's degree and 6 years; associate's degree and 10 years; or high school diploma/GED and 12 years.
Relevant experience must be in a public or private third-party access arena or the pharmaceutical industry in sales, managed care, or clinical support.
Demonstrated leadership, coaching, team development, and performance-management capability.
Expertise in Specialty Pharmacy (pharmacy benefit) and Buy & Bill (medical benefit) reimbursement, including prior authorization, appeals/denials, coding, billing, claims, benefit design, and patient support programs.
Understanding of commercial payer, Medicare, and Medicaid access and reimbursement dynamics, and ability to interpret payer policy and translate changes into field action.
Ability to lead and coach account management, business planning, and customer engagement in a field-based reimbursement organization.
Strategic planning, analytical reasoning, and fact-based decision-making skills, including interpreting quantitative and qualitative data, KPIs, payer policy, account insights, and performance trends.
Ability to establish team expectations and accountability, build team culture, and manage individual and team performance.
Cross-functional leadership and collaboration skills, including ability to influence across a complex matrix organization.
Commitment to ethical, legal, and compliance standards and experience leading teams within established field reimbursement rules of engagement.
Presentation, facilitation, coaching, and communication skills for working with field teams, customers, partners, and senior leadership.
Organizational and project management skills, including managing multiple priorities, leading change, and driving follow-through.
Experience using CRM and performance-management tools to monitor field execution, identify trends, and inform coaching and business decisions.

Nice To Haves

Bachelor's degree in business, healthcare, or a related field.
Five years of experience as a manager or first-line leader, or demonstrated people leadership with responsibility for coaching, developing, motivating, and managing performance.
Three years of experience in third-party access or the pharmaceutical/biotechnology industry in field reimbursement, managed care, market access, clinical support, or a related access role.
Experience in healthcare settings or services, including physician offices/clinics, specialty pharmacy, HUB services, insurance verification, claim adjudication, or pharmaceutical/biotechnology manufacturers.
Previous experience leading a field reimbursement team supporting specialty pharmaceutical or biologic products and/or launching products or indications.
Advanced experience with dual-benefit products and the operational differences between Specialty Pharmacy and physician-administered Buy & Bill channels.
Knowledge of Managed Care, Government and Federal payer sectors, Integrated Delivery Networks/Integrated Health Systems, and regional payer dynamics.
Advanced knowledge of medical insurance terminology, CMS policies and processes, reimbursement regulations, coding, coverage, and payment methodologies.
Experience developing talent, assessing readiness, building succession plans, and coaching leaders or future leaders.
Experience leading business reviews and using performance measures, market insights, and customer feedback to improve execution and access experience.
Experience partnering with training, operations, HUB, technology, and other enabling functions to improve field capabilities and processes.

Responsibilities

Lead, coach, develop, and retain Field Reimbursement Managers through clear expectations, regular coaching, field observations, feedback, performance management, and development planning.
Build a team culture grounded in accountability, collaboration, inclusion, trust, and positive momentum; recognize strong performance and address challenges constructively.
Establish performance expectations and hold the team accountable for field KPIs, service-level expectations, customer engagement measures, and business objectives.
Use performance data to identify trends, address gaps, and strengthen execution.
Meet Senior Manager field-time and coaching expectations, maintaining regional field presence to observe customer engagement, coach FRMs, assess market dynamics, and stay connected to access experiences.
Ensure excellent access experiences through reimbursement expertise, responsive customer engagement, issue resolution, follow-through, and compliant execution.
Develop and execute regional strategies that translate national access priorities into territory and account plans using payer, account, market, competitive, channel, and performance insights.
Coach FRMs in account management, analytical reasoning, fact-based decision-making, account and resource prioritization, account-specific access strategies, and adapting execution to market insights.
Maintain expertise in Specialty Pharmacy and Buy & Bill reimbursement and ensure team capability in the dual-benefit product model.
Monitor payer dynamics, reimbursement policy, competition, channel trends, reimbursement economics, and stakeholder practices, translating relevant insights into regional strategy and execution.
Lead compliant cross-functional collaboration with Sales, Key Account Management, Market Access, Medical, HUB, Operations, Training, and other partners to align priorities and resolve access barriers.
Lead regional business reviews and performance discussions, establish actions, and ensure follow-through.
Identify, escalate, and help resolve systemic access, reimbursement, process, or operational issues; communicate insights and recommendations to leadership and cross-functional partners.
Ensure team compliance with business rules, policies, procedures, privacy requirements, and field reimbursement rules of engagement through coaching, observations, and performance management.
Partner with Training and Capability Development to identify skill gaps, support onboarding, reinforce reimbursement and account-management capabilities, and advance continuous development.
Drive operational excellence through regional planning, resource prioritization, expense management, CRM adoption, timely documentation, escalation management, and consistent processes.
Hire and onboard talent, build succession and development plans, and empower team members to grow, take ownership, and deliver results.
Influence across a complex matrix organization, building trusted relationships and aligning stakeholders around access priorities and customer needs.