Field Reimbursement Manager- Milwaukee, Wisconsin

Amgen•Milwaukee, WI

23h•Remote

About The Position

Amgen is hiring a Field Reimbursement Manager to manage defined accounts within a specified geographic region and support Patient Access and Reimbursement for the Bone Health business unit. The territory covers Wisconsin, Northern Illinois, and Eastern Iowa. The role executes a collaborative territory strategic plan and helps healthcare providers understand reimbursement processes, field reimbursement services, and patient support programs. It also involves resolving patient-level reimbursement issues and handling patient health information when appropriate. The position is remote from a home office, with customer appointments in the territory and travel of up to 40%. Relocation is not included.

Requirements

Meet one of the following education and experience combinations: doctorate degree; master's degree and 3 years of customer service and/or leadership experience; bachelor's degree and 5 years; associate's degree and 10 years; or high school diploma/GED and 12 years.
Have experience directly managing people and/or leadership experience leading teams, projects, or programs, or directing resource allocation.
At least 2 years of experience in public or private third-party access or the pharmaceutical industry in managed care, clinical support, and/or sales.
Strong medical reimbursement experience and/or knowledge of specialty pharmacy and Buy & Bill.
Proven presentation and facilitation skills.
Strong written and oral communication skills.
Organizational skills and project management experience, including the ability to manage multiple projects.
Strong computer literacy, including Word, Excel, and PowerPoint, and the ability to conduct web-based meetings.
Healthcare-industry experience, such as insurance verification, claim adjudication, work with physician offices or clinics, pharmacies, and/or pharmaceutical manufacturers.
Proven experience with hubs and in-depth knowledge of billing, coding, and appeals issues across physician types.
Strong collaboration skills and ability to lead cross-functional partner meetings.
Experience with commercial payers, Medicare plans, and state Medicaid in a geographic region.
Live in the geography or within 10 miles of its border.
Must have a valid driver's license and a clean driving record.
Must be able to travel up to 40% by automobile or plane.

Nice To Haves

Bachelor's degree in business, healthcare, or a related field.
6 years of experience with specialty/biologic self-injectable products under the pharmacy benefit or physician-administered products under Buy & Bill/medical benefit.
Advanced knowledge of medical insurance terminology.
Knowledge of Centers for Medicare & Medicaid Services policies and processes, with expertise in Medicare Part B for Buy & Bill products and Part D for pharmacy products.
Ability to manage ambiguity and solve problems.
Ability to manage expenses within allocated budgets.

Responsibilities

Manage defined accounts within a specified geographic region for Patient Access and Reimbursement.
Execute the collaborative territory strategic plan in support of products.
Act as an extension of the HUB by providing live, one-on-one coverage support.
Assist across the reimbursement journey, from physician order through payer prior authorization, appeals, and denials requirements and forms.
Review patient-specific information when a site requests help resolving access or coverage issues.
Educate and update healthcare providers on private and public payer coverage and changes that affect patient product access.
Coordinate access and reimbursement issues with relevant partners, including the HUB.
Explain product coverage under commercial, Medicare, and Medicaid benefit designs.
Serve as a payer expert for the assigned geography and communicate payer changes promptly to stakeholders.
Educate offices on formulary coverage, utilization-management criteria, insurance forms and procedures, benefits investigations, prior authorizations, appeals, and claims resolution.
Educate offices using approved materials.
Review patient insurance benefit options and alternate funding or financial assistance programs.
Collaborate with other departments to resolve reimbursement issues.

Benefits

Comprehensive employee benefits package.
Retirement and Savings Plan with generous company contributions.
Group medical, dental, and vision coverage.
Life and disability insurance.
Flexible spending accounts.
Discretionary annual bonus program or, for field sales representatives, a sales-based incentive plan.
Stock-based long-term incentives.
Award-winning time-off plans.
Flexible work models where possible.
Career development opportunities.