Field Reimbursement Manager - Little Rock, AK

Amgen • Little Rock, AR

9d • Remote

About The Position

The Field Reimbursement Manager (FRM) manages defined accounts within a specified geographic region for Patient Access and Reimbursement, supporting Amgen’s Bone Health business unit. The role executes a collaborative territory strategic plan and helps healthcare providers understand reimbursement processes, field reimbursement services, and patient support programs. It includes resolving patient-level reimbursement issues and handling patient health information when needed. The territory covers Arkansas; relocation is not included.

The FRM acts as an extension of the HUB, provides one-on-one coverage support, and assists across the reimbursement journey from physician order through prior authorization, appeals, denials, and claims resolution. The role educates healthcare providers on payer coverage and changes, benefit design, formulary and utilization-management criteria, insurance procedures, benefits investigations, and financial assistance options. It coordinates access and reimbursement issues with the HUB and other partners, serves as a payer expert for the geography, and collaborates across departments.

The position is remote/work from home with customer appointments in the geography two days a week and one to two home-office days per week. Travel of up to 40% by automobile or plane is required. The role may involve prolonged sitting and keyboard work and requires a valid driver’s license with a clean driving record.

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 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. 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 involving areas such as 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 assigned geography or less than 10 miles from 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 under the pharmacy benefit or physician-administered products under the 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 solve problems.
• Ability to manage expenses within allocated budgets.

Responsibilities

• Manage defined accounts within the assigned geographic region for Patient Access and Reimbursement.
• Support products by executing the collaborative territory strategic plan.
• Promote understanding of reimbursement processes, field reimbursement services, and patient support programs.
• Resolve patient-level reimbursement issues, using knowledge and experience with patient health information when required.
• 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 forms and requirements.
• Review patient-specific information when a site requests help resolving coverage challenges or other issues.
• 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 key stakeholders.
• Provide office education on formulary coverage, utilization-management criteria, insurance forms and procedures, benefits investigations, prior authorizations, 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 and cross-functional partners to resolve reimbursement issues.
• Manage expenses within allocated budgets.

Benefits

• Comprehensive employee benefits package, including a Retirement and Savings Plan with generous company contributions.
• Group medical coverage.
• Dental coverage.
• Vision coverage.
• Life and 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: Manager
• Education Level: High school or GED