Field Reimbursement Manager

McKesson • Usa, GA

1d • 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 investigations, prior authorizations, claims assistance, and appeals, and educates physician offices about payer landscapes and available services through remote interactions and on-site training. This is a client- and customer-facing position that builds relationships with physician offices and manufacturer representatives and delivers services according to customer preferences. The FRM works independently in a fast-paced, highly visible environment and collaboratively with internal program hub support services to meet customer needs. The position involves frequent telephone interactions to arrange site visits, manufacturer trainings, and educational venues, and requires working knowledge of Medicare and commercial insurance plans and benefit structures. Travel, project management, and account coordination are required based on client expectations.

The position is remote and work-from-home, with the employee required to reside in the assigned territory and travel approximately 80% of the time (four days per week) by automobile or plane. The role may involve prolonged sitting and keyboard work and general office demands. The listed base pay range is $80,300–$133,800. Other compensation, such as an annual bonus or long-term incentive opportunities, may also be offered.

Requirements

• Four-year degree in a related field or equivalent experience.
• At least 4 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 skills and written and oral communication skills.
• Problem-solving and decision-making skills.
• Ability to reside in the assigned territory and travel 80% of the time (four days per 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 to office staff about reimbursement challenges and available support services, including Lunch and Learns and dinner presentations.
• Conduct an average of 15 on-site or virtual interactions per week and record activities in the FRM CRM daily, with weekly reporting to the manager.
• Educate offices on benefit investigations, prior authorization processes, Support Center services, Medicare and commercial coverage, and patient communication streams.
• Report educational topics monthly and provide quarterly trend reporting to clients, according to client expectations.
• Provide reimbursement support for case management, billing and coding updates, appropriate claims submission, specialty pharmacy, medical benefit interpretation, medical necessity, claims and appeals, co-pay 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, complete outbound calls to targeted offices, assist with backlog casework, and perform 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 reporting to management and clients.
• Monitor program performance for physicians and manufacturer representatives, review territory performance through the CRM dashboard, and identify trends for quarterly reporting.
• Research and compile provider- and manufacturer-representative-specific information for the reimbursement database, including account profiles.
• Create a facility database entry in the FRM CRM for each new provider.

Benefits

• Competitive compensation package.
• Annual bonus or long-term incentive opportunities may be offered.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level