Field Reimbursement Manager- Portland, OR

Amgen • Portland, OR

12d • $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 and supports products by executing the collaborative territory strategic plan. The role 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 Oregon, Idaho, Santa Rosa, California, and Redding, California, supporting the Bone Health business unit. Relocation is not included.

The FRM acts as an extension of the HUB, providing one-on-one coverage support and assistance 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, and payer changes; coordinates access and reimbursement matters with relevant partners; and provides office education using approved materials. The FRM also reviews insurance benefit options and financial assistance programs and collaborates across departments to resolve reimbursement issues.

The position is remote, with general office demands and customer appointments in the assigned geography two days per week. It includes one to two home-office days per week and travel of up to 40% by automobile or plane. A valid driver's license and clean driving record are required. The work may involve long periods of sitting and/or keyboard use.

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's 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.
• In addition to the applicable education and experience combination, have experience directly managing people and/or leadership experience leading teams, projects, or programs, or directing resource allocation. Managerial experience may run concurrently with 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 and project management experience, including the ability to manage multiple projects.
• Strong computer literacy, including Word, Excel, PowerPoint, and the 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.
• Ability to travel up to 40% by automobile or plane.
• Valid driver's license with a clean driving record.

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 and 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-and-bill products and Part D for pharmacy products.
• Ability to manage ambiguity and problem-solve.
• Ability to manage expenses within allocated budgets.

Responsibilities

• Manage defined accounts within a specified geographic region for Patient Access and Reimbursement.
• Support products by executing the collaborative territory strategic plan.
• 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 required forms.
• Review patient-specific information when a site requests assistance resolving coverage issues or 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 a payer expert for the defined geography and promptly communicate payer changes to stakeholders.
• Educate offices 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, dental, and vision coverage.
• Life and 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.
• Flexible work models where possible.
• Career development opportunities.

What This Job Offers

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