Field Reimbursement Manager
About The Position
McKesson is an impact-driven, Fortune 10 company that touches virtually every aspect of healthcare, known for delivering insights, products, and services that make quality care more accessible and affordable. They foster a culture where employees can grow, make an impact, and are empowered to bring new ideas. The Field Reimbursement Manager (FRM) is responsible for managing an assigned territory, supporting Reimbursement and Patient services by providing assistance with patient reimbursement challenges for a specific drug (including Benefit Investigation, Prior Authorization, Claims Assistance, and Appeals) and educating the office on Payer landscape and services available through both remote interaction and on-site training. This client-facing and customer-facing position requires the ability to build relationships with physician offices as well as manufacturer representatives to effectively deliver services based on customer specific preferences. The FRM works independently in a fast-paced, highly visible environment as well as collaboratively with internal program hub support services to ensure all customer needs are met. FRMs frequently interact via telephone with providers and internal staff to arrange site visits, Manufacturer trainings, and educational training venues. A solid working knowledge of Medicare and Commercial insurance plans and benefit structures is required to relay detailed benefit information and maximize the customer experience. The position will require travel, project management and/or account coordination based on client expectation. McKesson also includes CoverMyMeds, a fast-growing healthcare technology company focused on improving medication access.
Requirements
- 4-year degree in related field or equivalent experience
- 4+ years of healthcare related reimbursement experience
- Strong medical reimbursement experience with Buy & Bill and/or Specialty Pharmacy
- Experience in the healthcare industry including, but not limited to insurance verification, prior authorizations, and/or claim adjudication, physician’s office or clinics
- Must have Medicare and commercial insurance coverage experience
- Must be able to deliver and document benefit investigation outcomes and relay status reports on a regular basis
- Proven presentation skills and experience
- Proven ability to effectively handle multiple priorities and excellent organizational skills
- Strong Computer literacy to include PowerPoint and Web Meeting experience
- Must reside in territory
- Must be able to travel 80% (4 days a week) via automobile or plane
- Must have a valid driver's license with a clean driving record/ MVR
Nice To Haves
- Previous field experience
- Previous experience with specialty pharmacy
- Account management experience
- Excellent Interpersonal skills
- Excellent written and oral communication skills
- Problem solving and decision-making skills
Responsibilities
- Provide on-site and on-demand education (including Lunch and Learns or Dinner presentations) for the office staff in regard to Reimbursement challenges and support services that are available.
- Educate on Benefit Investigation, Prior Authorization Process, Support Center Services, Medicare and Commercial coverage and patient communication streams.
- Provide Reimbursement Support on Case management, billing and coding updates, appropriate claims submission, Specialty Pharmacy, Medical Benefit Interpretation, understanding medical necessity, claims and appeal assistance, information related to co-pay assistance and patient assistance programs.
- Collaborate with case manager on average of 4/month and ad hoc as needed for escalations.
- Responsible for setting up appointments and completing outbound calls to targeted offices.
- Assist in completing backlog casework.
- Interface with physicians and manufacturer representatives to obtain and provide patient and provider specific information.
- Monitor program performance for physicians and manufacturer representatives in accordance with expectations.
- Research and compile provider / manufacturer representative specific information for reimbursement database (Includes account profiles).
- Create a facility database on each new provider in FRM CRM.
Benefits
- Competitive compensation package
- Annual bonus or long-term incentive opportunities
- On-site culinary team (for CoverMyMeds)
- Flexible hours (for CoverMyMeds)
- Paid benefits (for CoverMyMeds)
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What This Job Offers
Job Type
Full-time
Career Level
Manager
Number of Employees
501-1,000 employees
