Field Reimbursement Specialist Senior Manager - West - Houston, TX

VetJobs•Houston, TX

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 effective 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 a compliant, high-quality access experience for customers and patients. The role uses payer, account, market, competitive, channel, and performance insights to guide regional strategy, develop team capabilities, and address access barriers across Specialty Pharmacy and Buy & Bill channels. It leads compliant cross-functional collaboration, regional business reviews, operational execution, and talent development. Unless specifically stated otherwise, the posting describes the role as on-site at the location detailed in the job post; the listed location is Houston, Texas.

Requirements

One of the following education and experience combinations: doctorate degree and 2 years of public or private third-party access arena or pharmaceutical industry experience in sales, managed care, or clinical support; master's degree and 4 years of such experience; bachelor's degree and 6 years; associate's degree and 10 years; or high school diploma/GED and 12 years.
Demonstrated commitment to ethical, legal, and compliance standards and experience leading teams within established field reimbursement rules of engagement.
Bachelor's degree in business, healthcare, or a related field.
Five years of manager/first-line leader experience or demonstrated people leadership with responsibility for coaching, developing, motivating, and managing others' performance.
Three years of public or private third-party access arena or pharmaceutical/biotechnology industry experience in field reimbursement, managed care, market access, clinical support, or a related access role.
Expertise in Specialty Pharmacy and Buy & Bill reimbursement, including prior authorization, appeals/denials, coding, billing, claims, benefit design, and patient support programs, with ability to lead a team supporting a dual-benefit product model.
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 a strong 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.
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

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 the 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 Field Reimbursement Managers through clear expectations, regular coaching, field observations, feedback, performance management, and development planning.
Build a team culture grounded in accountability, collaboration, inclusion, trust, and positive momentum, while reinforcing Amgen Values and expected 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 address gaps.
Meet established Senior Manager field-time and coaching expectations and maintain regional field presence to observe customer engagement, coach FRMs, assess market dynamics, and stay connected to the customer access experience.
Ensure excellent access experiences 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 decision-making, account prioritization, access strategy development, and adapting execution based on insights.
Maintain expertise in Specialty Pharmacy and Buy & Bill reimbursement and ensure the team can 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 access priorities, resolve barriers, and improve customer experience within rules of engagement.
Lead regional business reviews and performance discussions using field KPIs, account insights, payer trends, access barriers, and opportunities; establish actions and ensure follow-through.
Identify, escalate, and help resolve systemic access, reimbursement, process, and operational issues; communicate insights and recommendations to leadership and cross-functional partners.
Ensure team compliance with business rules, policies, procedures, privacy requirements, and field reimbursement rules of engagement through coaching, observations, 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 continuous development.
Drive operational excellence through regional planning, resource prioritization, expense management, CRM adoption, 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.
Lead through influence across a complex matrix organization, building trusted relationships and aligning stakeholders around access priorities and customer needs.