Field Reimbursement Specialist Senior Manager - West - Denver, CO

VetJobs•Denver, CO

3d•$176,905 - $239,341•Onsite

About The Position

The Tezspire Field Reimbursement Regional Senior Manager leads a regional team of Field Reimbursement Managers and executes reimbursement strategy to support optimal access to Tezspire in the Respiratory therapeutic area. The role builds and coaches a high-performing team, translates national and regional priorities into field execution, and fosters accountability, collaboration, inclusion, and positive momentum. The Senior Manager is accountable for team performance against field KPIs and service expectations, including personal and team field-time measures, while ensuring an excellent, compliant access experience for customers and patients. The position uses payer, account, market, competitive, channel, and performance insights to guide regional strategy, develop FRM capability, and address access barriers across Specialty Pharmacy and Buy & Bill channels. It leads regional planning, business reviews, compliant cross-functional collaboration, operational execution, talent development, and performance management. The role is listed in Denver, Colorado; the posting says the role is on-site unless specifically stated otherwise.

Requirements

A qualifying combination of education and experience: doctorate degree plus 2 years; master's degree plus 4 years; bachelor's degree plus 6 years; associate's degree plus 10 years; or high school diploma/GED plus 12 years of experience in a public or private third-party access arena or pharmaceutical industry in sales, managed care, or clinical support.
Demonstrated expertise in Specialty Pharmacy (pharmacy benefit) and Buy & Bill (medical benefit) reimbursement, including prior authorization, appeals/denials, coding, billing, claims, benefit design, and patient support programs.
Strong understanding of commercial payer, Medicare, and Medicaid access and reimbursement dynamics, and ability to interpret payer policy and translate changes into field action.
Ability to lead and coach account management, business planning, and customer engagement within a field-based reimbursement organization.
Strategic planning, analytical reasoning, and fact-based decision-making skills, including interpreting quantitative and qualitative data, field KPIs, payer policy, account insights, and performance trends.
Ability to build team culture, establish expectations, create accountability, and manage individual and team performance.
Strong cross-functional leadership and collaboration skills, including influencing outcomes across a complex matrix organization.
Commitment to ethical, legal, and compliance standards, with experience leading teams within established field reimbursement rules of engagement.
Presentation, facilitation, coaching, and communication skills for working with field teams, customers, cross-functional partners, and senior leadership.
Organizational and project management skills, including managing multiple priorities, leading change, and ensuring timely follow-through.
Experience using CRM and performance-management tools to monitor field execution, identify trends, and support coaching and business decisions.
Healthcare industry experience, including physician offices/clinics, specialty pharmacy, HUB services, insurance verification, claim adjudication, or pharmaceutical/biotechnology manufacturers.

Nice To Haves

Bachelor's degree in business, healthcare, or a related field.
Five years of experience as a manager/first-line leader, or demonstrated people leadership experience coaching, developing, motivating, and managing performance.
Three years of experience in third-party access or the pharmaceutical/biotechnology industry in field reimbursement, managed care, market access, clinical support, or a related access role.
Previous experience leading a field reimbursement team supporting specialty pharmaceutical or biologic products and/or launching new products or indications.
Advanced experience with dual-benefit products and operational differences between Specialty Pharmacy and physician-administered Buy & Bill channels.
Knowledge of Managed Care, Government and Federal payer sectors, Integrated Delivery Networks/Integrated Health Systems, and regional payer dynamics.
Advanced knowledge of medical insurance terminology, CMS policies and processes, reimbursement regulations, coding, coverage, and payment methodologies.
Experience developing talent, assessing readiness, building succession plans, and coaching leaders or future leaders.
Experience leading business reviews and using performance measures, market insights, and customer feedback to improve field execution and access experience.
Experience partnering with training, operations, HUB, technology, and other enabling functions to improve field capabilities and processes.

Responsibilities

Lead, coach, develop, and retain a high-performing team of Field Reimbursement Managers through clear expectations, coaching, field observations, feedback, performance management, and development planning.
Build a team culture grounded in accountability, collaboration, inclusion, trust, and positive momentum; recognize performance, address challenges constructively, and reinforce Amgen Values and leadership behaviors.
Set performance expectations and hold the team accountable for field KPIs, service levels, customer engagement measures, and business objectives; use performance data to identify trends and strengthen execution.
Meet established Senior Manager field-time and coaching expectations, maintaining appropriate field presence to observe customer engagement, coach FRMs, assess market dynamics, and stay connected to the customer access experience.
Ensure consistent delivery of an excellent access experience through reimbursement expertise, responsive customer engagement, issue resolution, follow-through, and compliant execution.
Develop and execute regional strategies that translate national access priorities into territory and account plans, using payer, account, market, competitive, channel, and performance insights.
Coach FRMs in account management, analytical reasoning, fact-based decisions, account prioritization, resource allocation, account-specific access strategies, and adapting execution based on insights.
Maintain expertise in Specialty Pharmacy and Buy & Bill reimbursement and ensure team capability to navigate the dual-benefit product model.
Monitor payer dynamics, reimbursement policy, competition, channel trends, reimbursement economics, and stakeholder practices; translate insights into regional strategy and team execution.
Lead compliant cross-functional collaboration with Sales, Key Account Management, Market Access, Medical, HUB, Operations, Training, and other partners to align priorities and resolve access barriers.
Lead regional business reviews and performance discussions, integrating KPIs, account insights, payer trends, barriers, and opportunities; establish actions and ensure follow-through.
Identify, escalate, and help resolve systemic access, reimbursement, process, and operational issues; communicate insights and recommended actions to leadership and partners.
Ensure team compliance with business rules, policies, procedures, privacy requirements, and field reimbursement rules of engagement through coaching, observation, virtual engagement, and performance management.
Partner with Training and Capability Development to identify skill gaps, support onboarding, reinforce reimbursement and account-management capabilities, and advance development.
Drive operational excellence through regional planning, resource prioritization, expense management, CRM adoption, timely documentation, escalation management, and consistent processes.
Hire and onboard talent, build succession and development plans, and create an environment that empowers team members to grow, take ownership, and deliver results.
Influence across a complex matrix organization, building trusted relationships and aligning stakeholders around access priorities and customer needs.