Field Reimbursement Manager - Botox Therapeutic
About The Position
The Field Reimbursement Manager (FRM) is a field-based role supporting approved indications for BOTOX® Therapeutics. The FRM educates healthcare providers and account staff on medical and pharmacy benefits, Buy & Bill and Specialty Pharmacy acquisition, payer policies, patient identification, clinical documentation, benefit investigations, prior authorizations, billing and coding, patient tracking, claim submission, reconciliation, financial savings programs, retreatment, and denial and appeal processes. The role identifies barriers that may delay appropriate treatment or affect patient outcomes and may work with healthcare providers, administrative staff, revenue cycle management, and institutional leadership. The FRM provides education on the BOTOX treatment and reimbursement processes and payer landscape, identifies access barriers and their root causes, and offers actionable, need-based solutions. The role monitors regional and national payer changes and shares critical information through compliant methods. It also works as a liaison among internal groups and provides customer feedback on approval requirements and access barriers. The position establishes relationships with healthcare professionals, staff, and business decision-makers, including C-suite executives. The FRM influences across functions, leads without authority, communicates complex or challenging information professionally, and contributes solutions in a fast-changing environment. The role requires planning, prioritization, follow-up, and compliance with AbbVie and regulatory requirements. The territory includes San Francisco and San Jose, California; candidates should live within a reasonable distance of the primary city. Travel is approximately 50%, and some overnight travel may be required.
Requirements
- At least 5–7 years of proven success in a healthcare-related field.
- Bachelor’s degree required.
- Exposure to physician-administered injectables; CPT and/or J-code reimbursement; Specialty Pharmacy and Buy & Bill acquisition; benefit verifications; prior authorizations; claim assistance; appeals; payer policies; and HUB services.
- Proven record of comprehensive work with accounts at all levels.
- Payer or insurance coverage experience with Medicare, Medicare Advantage, commercial, and Medicaid plans.
- Well-developed verbal and written communication skills, including in-person and virtual presentation of complex information and processes.
- Demonstrated competence in problem solving, gaining access, resource mastery, achieving tangible results, overcoming adversity, collaboration, and managing complexities.
- Demonstrated empathy, critical thinking, curiosity, persistence, reliability, and resourcefulness.
- Strong history of leadership in a current role.
- Technology and analytical skills, including Salesforce, virtual meetings, Excel, and report interpretation.
- Ability to drive a personal auto or company car or truck, or powered material-handling equipment.
- Valid driver’s license, ability to pass a pre-employment drug screening test, and ability to meet safe-driving requirements.
- Ability to travel adequately to cover the territory and attend training and meetings; some overnight travel may be required.
Nice To Haves
- Previous Sales, District Management, Hospital, Managed Markets, Access and Reimbursement, or practice experience.
- Knowledge of Lean Six Sigma principles.
Responsibilities
- Educate accounts on the fundamentals of the BOTOX treatment process, appropriate reimbursement, and the payer landscape.
- Identify access and reimbursement barriers, uncover their root causes, and provide actionable insights and solutions to support appropriate care.
- Monitor regional and national payer updates, including changes to medical policy, prior authorization requirements, and product acquisition, and exchange information using compliant methods.
- Collaborate and serve as an information liaison among internal stakeholders, including Market Access, Center of Excellence, Sales, Marketing, Training, Compliance, Trade, and Specialty Pharmacy groups.
- Provide customer feedback to AbbVie stakeholders about approval requirements and barriers to access to care.
- Educate accounts about need-based patient access tools, including HUB services, patient savings programs, payer coverage details, and acquisition pull-through initiatives.
- Establish and maintain respectful working relationships with healthcare professionals, staff, and business decision-makers, including C-suite executives.
- Lead without authority, communicate with diverse groups, influence across functions, and build consensus around patient solutions.
- Deliver crucial conversations professionally, including when communicating unfavorable information or facts.
- Participate proactively in Field Input Teams and share customer challenges and potential solutions.
- Plan and prioritize effectively, follow up, and anticipate problems.
- Conduct all work activities in compliance with AbbVie internal requirements and applicable regulations.
Benefits
- Paid time off, including vacation, holidays, and sick time.
- Medical, dental, and vision insurance for eligible employees.
- 401(k) for eligible employees.
- Eligibility to participate in long-term incentive programs.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
