Field Reimbursement Manager - Botox Therapeutic
About The Position
The Field Reimbursement Manager (FRM) educates healthcare providers and other account stakeholders on medical and pharmacy benefits, Buy & Bill and Specialty Pharmacy acquisition, payer policy, patient identification, clinical documentation, benefit investigations, prior authorizations, billing and coding, patient tracking, claim submission and reconciliation, financial savings programs, retreatment, and denial and appeal processes for approved BOTOX® Therapeutic indications. The FRM identifies and helps address barriers that may delay appropriate treatment or prevent optimal patient outcomes, working with healthcare providers, administrative staff, revenue cycle teams, and institutional leaders. This is a field-based role covering Minnesota and North Dakota. The employee should live within a reasonable distance of the primary city, travel to cover the territory and attend training and meetings, and may need to travel overnight. Travel is listed as 50% of the time. The level of hire will be commensurate with experience. The role is eligible for long-term incentive programs. The stated annual base-pay range is USD 139,000–250,500, subject to factors including geographic location and other considerations.
Requirements
- Bachelor’s degree required.
- A minimum of 5–7 years of proven success in a healthcare-related field.
- 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 presentations of complex information and processes.
- Consistent 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 the current role.
- Technology and analytical skills, including Salesforce, virtual meetings, Excel, and report interpretation.
- Valid driver’s license.
- Ability to travel adequately to cover the territory and attend training and meetings; some overnight travel may be required.
- Ability to live within a reasonable distance of the primary city for the field-based territory covering Minnesota and North Dakota.
Nice To Haves
- Previous sales, district management, hospital, managed markets, access and reimbursement, or practice experience.
- Knowledge of Lean Six Sigma principles.
- 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.
Responsibilities
- Educate accounts on the BOTOX treatment process, appropriate reimbursement, and the payer landscape.
- Identify access and reimbursement barriers, uncover root causes, and provide actionable, compliant insights and solutions to support appropriate care.
- Monitor and communicate regional and national payer updates, including changes to medical policies, prior authorization requirements, and product acquisition.
- Serve as a liaison and collaborate with internal groups including Market Access, Center of Excellence, Sales, Marketing, Training, Compliance, Trade, and Specialty Pharmacy.
- Share customer feedback and challenges related to approval requirements and access to care with relevant AbbVie stakeholders, and suggest potential solutions.
- Educate accounts on need-based patient-access tools, including HUB services, patient savings programs, payer coverage details, and acquisition pull-through initiatives.
- Develop analytical, customized solutions for complex environments and matrix-influenced health systems and practices.
- Establish and maintain respectful relationships with healthcare professionals, staff, business decision makers, and C-suite executives within the territory.
- Lead without authority, communicate with diverse groups, influence across functions, and build consensus on patient solutions.
- Professionally deliver crucial conversations, including information that may be less desirable.
- Participate proactively in Field Input Teams and offer innovative solutions in a fast-changing environment.
- Plan and prioritize effectively, follow up, and anticipate problems.
- Conduct all work in compliance with AbbVie 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
