Field Reimbursement Manager

CSL

1d•Hybrid

About The Position

The Field Reimbursement Manager will be responsible for managing the day-to-day tactical field-based reimbursement activities in their geography. This includes conducting field reimbursement in-services and educational workshops for Patient Advocacy groups, Health Care Professional (HCP) offices, Specialty Pharmacies, and distributors for all CSL therapies. The role involves working with payer and channel Customer Account Managers to educate and resolve reimbursement issues, and collaborating with the field sales organization and third-party patient access programs to improve patient access to therapies. Additionally, the manager will work directly with consumer groups for reimbursement education and training, and manage relationships with regional Medicare offices and Carrier Advisory Committees.

Requirements

Bachelor degree required (business, business management, health policy, health economics, life sciences or healthcare discipline)
7+ years' pharmaceutical industry experience in reimbursement or case management
Prior reimbursement or case management experience required
Strong understanding of relevant market reimbursement policy
Work experience with patient advocacy groups regarding coverage policies
Excellent verbal and written communication skills
Demonstrated ability to work both independently and in group settings

Nice To Haves

Prior work with patient advocacy group desirable

Responsibilities

Work with payers, specialty pharmacies, physicians, physician support staff, and professional societies to secure adequate reimbursement of CSL Behring therapies.
Aid physicians, sites of service and their support staff in the reimbursement process.
Provide in-service training to sales and marketing on the fundamentals of healthcare economics.
Execute reimbursement strategies that proactively integrate and align with marketing and sales objectives.
Work directly with third party payers and Medicare offices to insure adequate reimbursement for our products.
Provide monthly report recounting significant activities, progress and follow-up needed.
Assess reimbursement environment (coverage, coding and payment) for any new products and procedures.
Work with payer and channel Customer Account Managers in educating and resolving reimbursement issues with SP (Specialty Pharmacy) accounts and attend customer account calls with payer and channel CAMs as needed to present reimbursement information on CSL therapies and answer any questions the accounts may have.
Work with field sales organization and third-party patient access programs via patient access hotline (HUB) to resolve reimbursement issues and improve patient access to therapies.
Perform field reimbursement in-services such as account visits, presentations to healthcare providers and other medical staff.
Conduct billing procedure review for home care companies, pharmacies, and other providers experiencing inadequate reimbursement across the portfolio.
Work directly with consumer groups to supply reimbursement education and training. This should be accomplished by attending and conducting patient education workshops at regional and national consumer group meetings (IDF, JMF, HAEA, NHF, etc.).
Work with consumer groups as needed to coordinate the use of CSL Behring Assurance and Assistance programs.
Collaborate with the Patient Services team to ensure the Hub offerings are up to date with the changing reimbursement landscape, including HUB training and managing challenging cases.
Attend trade shows (AAAAI, HAEA, NHF, NHIA AMCP, CMSA, etc.), and be able to present reimbursement information as requested by the various groups.
Work with the Sr. Director of Reimbursement in developing and executing on tactical programs for strategic accounts.