Field Reimbursement Manager

McKesson•Work at Home - Pennsylvania, USA (WPAA), NJ

4d•$80,300 - $133,800•Remote

About The Position

The CoverMyMeds Field Reimbursement Manager (FRM) manages an assigned territory and supports reimbursement and patient services for a specific drug. The role helps address patient reimbursement challenges, including benefit investigation, prior authorization, claims assistance, and appeals, and educates physician-office staff about payer landscapes and available services through remote interactions and on-site training. This is a client- and customer-facing role requiring relationship-building with physician offices and manufacturer representatives. The FRM works independently in a fast-paced, highly visible environment and collaborates with internal program hub support services to meet customer needs. The position involves frequent telephone contact to arrange site visits, manufacturer trainings, and educational events; a working knowledge of Medicare and commercial insurance plans and benefit structures; travel; and project management and/or account coordination according to client expectations. The position is remote, work-from-home, with residence in the assigned territory and travel of approximately 80% (four days a week) by automobile or plane. It may involve extended periods of sitting and/or keyboard work and general office demands.

Requirements

Four-year degree in a related field or equivalent experience.
At least four years of healthcare-related reimbursement experience.
Strong medical reimbursement experience with Buy & Bill and/or specialty pharmacy.
Healthcare industry experience, including insurance verification, prior authorizations, claims adjudication, or work in a physician's office or clinic.
Experience with Medicare and commercial insurance coverage.
Ability to deliver and document benefit investigation outcomes and regularly relay status reports.
Proven presentation skills and experience.
Ability to handle multiple priorities effectively and strong organizational skills.
Strong computer literacy, including PowerPoint and web meeting experience.
Excellent interpersonal, written communication, and oral communication skills.
Problem-solving and decision-making skills.
Must reside in the territory.
Must be able to travel 80% (four days a week) by automobile or plane.
Valid driver's license and clean driving record/MVR.

Nice To Haves

Previous field experience.
Previous specialty pharmacy experience.
Account management experience.

Responsibilities

Provide on-site and on-demand education, including lunch-and-learns and dinner presentations, about reimbursement challenges and available support services. Average 15 on-site or virtual interactions per week; record activities in the FRM CRM daily and report to the manager weekly.
Educate offices on benefit investigation, prior authorization, support center services, Medicare and commercial coverage, and patient communication streams; report educational topics monthly and provide trended data quarterly to clients.
Provide reimbursement support relating to case management, billing and coding updates, claims submission, specialty pharmacy, medical benefit interpretation, medical necessity, claims and appeals assistance, copay assistance, and patient assistance programs.
Collaborate with case managers an average of four times per month and as needed for escalations; track interactions in the FRM CRM and hub system.
Set up appointments, make outbound calls to targeted offices, assist with backlog casework, and complete other day-to-day in-office work.
Interface with physicians and manufacturer representatives to obtain and provide patient- and provider-specific information.
Track FRM interactions and activities in the FRM CRM for management and client reporting.
Monitor physician and manufacturer representative program performance using the FRM CRM dashboard, identify trends through quarterly reporting, and support customer surveys when clients elect to conduct them.
Research and compile provider- and manufacturer-representative-specific reimbursement information, create facility databases for new providers in the FRM CRM, and use the database to build interaction and activity records.