Field Reimbursement Manager, California

Recordati•Bridgewater, NJ

2d•Remote

About The Position

The Field Reimbursement Manager (FRM) manages accounts in a specified region, focusing on but not limited to endocrinology. The role provides healthcare providers (HCPs) and office personnel with access and reimbursement education, including information about medical policies, prior authorization requirements, coding and billing, and product access through buy-and-bill or specialty pharmacy. The goal is to minimize barriers to therapy. The FRM also provides general education and case-specific next steps for appeals following prior authorization denials. The position involves on-site time with HCPs to assess their access and reimbursement education needs and facilitate collaboration with stakeholders. The FRM serves as a subject matter expert on coverage, access, reimbursement, and the regional access landscape, offering compliant, limited support to U.S. HCPs and office staff after an HCP has independently decided to prescribe an RRD product. The role collaborates with internal and external stakeholders on account strategy and individual case needs, follows up with HCP staff and specialty pharmacies on outstanding prior authorizations and appeals, and shares field insights to inform internal stakeholders. This is a remote role in California, with proximity to a major airport and approximately 30–40% need-based travel. The position reports to the Associate Director, Field Reimbursement and has no direct reports.

Requirements

Bachelor’s degree.
Experience in a field-based role working with provider offices and/or patient support hub services.
Five to seven years of experience in the healthcare and/or pharmaceutical industry.
At least three years of successful field reimbursement experience.
At least two years of experience working with buy-and-bill and/or specialty pharmacy networks.
Ability to analyze and interpret regulations and legislation related to coding, coverage, and reimbursement.
In-depth knowledge of the U.S. pharmaceutical market, specifically rare diseases.
Reimbursement or relevant managed-care experience, including buy-and-bill, prior authorization, coding, and appeals processes.
Problem-solving ability to navigate challenging access scenarios and identify solutions efficiently and promptly.
Comfort presenting in person or virtually to healthcare practitioner office staff.
Strong written and verbal communication skills and efficient follow-through.
Strong relationship-building skills and demonstrated ability to collaborate across functions.
Strong planning and organizational skills, with demonstrated decision-making ability.
Reliable transportation within the territory; valid driver’s license and means of transportation.
Proficiency in Microsoft Office.
Demonstrated high ethical standards.
Ability to prioritize and multitask effectively.
Ability to travel domestically and internationally as business needs require.
Ability to move or transport items weighing up to 25 pounds, with or without accommodations.

Responsibilities

Partner with cross-functional parties on account and territory strategy to improve internal and external customer knowledge of payer policies and processes.
Provide compliant, limited reimbursement support to U.S. healthcare providers and office staff after the provider independently decides to prescribe an RRD product.
Educate HCPs and office personnel about coverage, access, reimbursement, medical policies, prior authorizations, coding and billing, and product access through buy-and-bill or specialty pharmacy.
Collaborate with HCP staff and specialty pharmacies to follow up on accounts with outstanding prior authorization or appeals submissions.
Provide general education and case-specific next steps for appeals in response to prior authorization denials.
Serve as a subject matter expert on reimbursement and regional access, including payer policies, prior authorizations, denials, appeals, and peer-to-peer processes.
Collaborate with cross-functional parties on case-management needs related to HCP reimbursement education.
Collect field insights on payer trends, reimbursement challenges, and provider needs for internal stakeholders.
Use available resources, including internal data, to develop and execute account plans and call purposes.
Comply with laws, regulations, company policies, and the company’s Code of Ethics and Business Conduct.
Comply with the annual budget allocation for the territory.
Perform additional duties as assigned.
Travel to HCP offices and meetings, including occasional out-of-state travel over weekends and nights, as business needs require.