Field Reimbursement Manager (FRM), Ophthalmology – United States

Merk

7d • $114,700 - $180,500 • Remote

About The Position

The Field Reimbursement Manager (FRM), Ophthalmology is a remote, field-based role serving as a subject-matter expert on access-related issues for healthcare professionals and healthcare organizations. The FRM provides approved education and information on reimbursement, payer coverage, access processes, and patient support programs to help support timely and appropriate patient access to therapy after a prescribing decision. The role operates within the organization’s non-promotional field access model and complies with healthcare regulations and company policies.

The FRM supports defined accounts within an assigned geography, analyzes reimbursement and access challenges, and acts as a local resource for healthcare provider offices and internal field teams. The position collaborates with Patient Support Services, Market Access, Account Management, Medical Affairs, Field Sales, National Account Directors, Key Account Managers, Trade, specialty pharmacy partners, HUB vendors, and other customer-facing teams. The role also supports buy-and-bill operational readiness and helps ophthalmology practices understand available access and reimbursement resources.

Requirements

• Bachelor’s degree.
• At least 7 years of experience in patient support, healthcare sales, healthcare operations, project management, reimbursement support, specialty pharmacy, market access, provider office reimbursement, or related healthcare environments.
• Strong knowledge of health insurance structures, including Medicare Part B, Medicaid, and commercial insurance, and related access processes such as benefit verification, prior authorization, reimbursement support, and appeals.
• Expertise in pharmaceutical compliance requirements and HIPAA regulations regarding patient confidentiality.
• Excellent interpersonal and communication skills, with demonstrated ability to engage and influence diverse stakeholders.
• Demonstrated understanding of HUB services and patient support activities.
• Ability to manage multiple priorities in a dynamic field-based environment.
• Ability to collaborate with Field Sales, Account Management, Market Access, Patient Support Services, and internal business partners.
• Must reside within the assigned territory or geography.
• Must possess a valid driver’s license and meet all applicable driving requirements.
• Ability to travel approximately 50–75%, based on territory requirements.
• Required skills include access and reimbursement education, account planning, benefit verification, buy-and-bill reimbursement, customer focus, healthcare policy knowledge, market access strategy, Medicare Part B knowledge, patient support programs, payer coverage analysis, prior authorization processes, reimbursement support, stakeholder management, strategic thinking, and territory management.

Nice To Haves

• Strong understanding of buy-and-bill reimbursement environments and provider-administered therapies.
• Ophthalmology, retina, biologics, specialty therapeutics, or provider-administered product experience.
• Experience supporting buy-and-bill products.
• Understanding of retina practice operations, reimbursement workflows, coding and billing considerations, and provider economics.
• Experience with patient support programs, specialty pharmacies, and reimbursement HUB operations.
• Product launch experience within specialty pharmaceutical or biotechnology markets.
• Preferred skills include coding and billing knowledge, HUB operations, medical benefit reimbursement, ophthalmology experience, provider economics, retina market experience, site-of-care knowledge, and specialty therapeutics experience.

Responsibilities

• Provide approved information and education to healthcare provider offices on benefit verification, prior authorization, appeals, coding and billing considerations, patient support programs, and patient access through in-person and virtual interactions.
• Analyze access trends and reimbursement challenges affecting patient access and communicate insights through approved channels.
• Partner cross-functionally to identify and address patient access barriers and support positive customer experiences.
• Build collaborative relationships with retina specialists, ophthalmologists, practice administrators, reimbursement personnel, billing staff, and internal stakeholders.
• Monitor payer trends, reimbursement requirements, and policy changes that may affect patient access.
• Provide approved access and reimbursement information to healthcare provider offices and internal stakeholders as permitted by policy.
• Escalate and coordinate reimbursement and access issues with approved third-party support organizations, including HUB vendors and patient support programs.
• Educate and support healthcare provider offices regarding specialty pharmacy processes when appropriate.
• Provide information on commercial, Medicare Part B, and Medicaid coverage considerations and established benefit structures.
• Answer questions about payer coverage requirements and approved reimbursement support resources.
• Maintain knowledge of regional and national market dynamics, payer coverage policies, reimbursement trends, and healthcare access considerations.
• Serve as a subject-matter expert on reimbursement, affordability, and patient access challenges across Medicare, Medicaid, and commercial payer channels.
• Educate and update healthcare providers about payer policy changes affecting patient access.
• Support buy-and-bill access and reimbursement readiness within retina and ophthalmology practices through approved education and resources.
• Educate healthcare providers about HUB services, patient support offerings, affordability resources, and available reimbursement support tools.
• Attend national, regional, and territory meetings as required.

Benefits

• Annual bonus and long-term incentive, if applicable.
• Medical, dental, vision healthcare, and other insurance benefits for employees and family.
• Retirement benefits, including 401(k).
• Paid holidays, vacation, compassionate days, and sick days.

What This Job Offers

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