Field Reimbursement Manager

McKesson•Work at Home - Arizona, USA DAYLIGHT (WAZM), AZ

1d•$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 physician offices address patient reimbursement challenges, including benefit investigation, prior authorization, claims assistance, and appeals, while educating office staff about payer landscapes and available services through remote interactions and on-site training. This client-facing and customer-facing position builds relationships with physician offices and manufacturer representatives to deliver services according to customer preferences. The FRM works independently in a fast-paced, highly visible environment and collaborates with internal program hub support services. The role requires a solid working knowledge of Medicare and commercial insurance plans and benefit structures, along with project management and/or account coordination based on client expectations. It involves frequent telephone contact to arrange site visits, manufacturer trainings, and educational venues, and requires travel within the assigned territory.

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 physician offices or clinics.
Experience with Medicare and commercial insurance coverage.
Ability to deliver and document benefit investigation outcomes and relay status reports regularly.
Proven presentation skills and experience.
Ability to handle multiple priorities effectively, with excellent organizational skills.
Strong computer literacy, including PowerPoint and web meeting experience.
Excellent interpersonal skills.
Excellent written and oral communication skills.
Problem-solving and decision-making skills.
Must reside in the assigned territory.
Ability 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 experience with specialty pharmacy.
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 or Dinner presentations; average 15 on-site or virtual interactions per week and record them in the FRM CRM daily.
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 to clients quarterly.
Support case management, billing and coding updates, claims submission, specialty pharmacy, medical benefit interpretation, medical necessity, claims and appeals, copay assistance, and patient assistance programs.
Collaborate with case managers, averaging four interactions per month and additional interactions 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 all interactions and activities in the FRM CRM.
Monitor physician and manufacturer representative program performance using the FRM CRM dashboard and identify trends through quarterly reporting; support optional customer surveys on program performance.
Research and compile provider- and manufacturer representative-specific information for the reimbursement database, create facility databases for new providers in the FRM CRM, and use those databases to build interactions and activities.