Field Reimbursement Specialist Senior Manager - West - Houston, TX

Military Spouse Corporate Career Network•Houston, TX

1d•Onsite

About The Position

The Tezspire Field Reimbursement Regional Senior Manager leads a regional team of Field Reimbursement Managers and executes reimbursement strategy to support optimal access to Tezspire within the Respiratory therapeutic area. The role develops a high-performing team, translates national and regional priorities into field execution, and builds a culture of accountability, collaboration, inclusion, and positive momentum. The Senior Manager is accountable for team performance against field KPIs and service expectations, including field-time measures, and for delivering a consistent, compliant access experience for customers and patients. The role uses payer, account, market, competitive, channel, and performance insights to guide regional strategy, develop team capability, and address access barriers across Specialty Pharmacy and Buy & Bill channels. It includes coaching and observing FRMs in the field, leading regional business reviews, collaborating with cross-functional partners, managing operational execution, and ensuring compliance with applicable policies and rules of engagement.

Requirements

Doctorate degree and 2 years of public or private third-party access arena or pharmaceutical industry experience in sales, managed care, or clinical support; OR master’s degree and 4 years; OR bachelor’s degree and 6 years; OR associate’s degree and 10 years; OR high school diploma/GED and 12 years.
Demonstrated ability to lead and coach account management, business planning, and customer engagement within a field-based reimbursement organization.
Strong understanding of commercial payer, Medicare, and Medicaid access and reimbursement dynamics, including interpreting payer policy and translating changes into field action.
Demonstrated expertise in Specialty Pharmacy (pharmacy benefit) and Buy & Bill (medical benefit) reimbursement, including prior authorization, appeals/denials, coding, billing, claims, benefit design, and patient support programs.
Proven strategic planning, analytical reasoning, and fact-based decision-making skills, including interpreting quantitative and qualitative data, field KPIs, payer policy, account insights, and performance trends.
Ability to build team culture, establish expectations, create accountability, and manage individual and team performance.
Strong cross-functional leadership and collaboration skills, with ability to influence in a complex matrix organization.
Commitment to ethical, legal, and compliance standards and experience leading teams within established field reimbursement rules of engagement.
Strong presentation, facilitation, coaching, and communication skills for interactions with field teams, customers, cross-functional partners, and senior leadership.
Organizational and project management skills, including managing priorities, leading change, and ensuring timely follow-through.
Experience using CRM and performance-management tools to monitor field execution, identify trends, and support coaching and business decisions.
Healthcare industry experience, including physician offices/clinics, specialty pharmacy, HUB services, insurance verification, claim adjudication, or pharmaceutical/biotechnology manufacturers.

Nice To Haves

Bachelor’s degree in business, healthcare, or a related field.
Five years of experience as a manager/first-line leader or demonstrated people leadership experience coaching, developing, motivating, and managing others’ performance.
Three years of experience in third-party access or the pharmaceutical/biotechnology industry in field reimbursement, managed care, market access, clinical support, or a related access role.
Previous experience leading a field reimbursement team supporting specialty pharmaceutical or biologic products and/or launching new products or indications.
Advanced experience with dual-benefit products and the operational differences between Specialty Pharmacy and physician-administered Buy & Bill channels.
Knowledge of Managed Care, Government and Federal payer sectors, Integrated Delivery Networks/Integrated Health Systems, and regional payer dynamics.
Advanced knowledge of medical insurance terminology, CMS policies and processes, reimbursement regulations, coding, coverage, and payment methodologies.
Experience developing talent, assessing readiness, building succession plans, and coaching leaders or future leaders.
Experience leading business reviews and using performance measures, market insights, and customer feedback to improve field execution and access experience.
Experience partnering with training, operations, HUB, technology, and other enabling functions to improve field capabilities and processes.

Responsibilities

Lead, coach, develop, and retain Field Reimbursement Managers through clear expectations, coaching, field observations, feedback, performance management, and development planning.
Build a team culture based on accountability, collaboration, inclusion, trust, and positive momentum; recognize performance and address challenges constructively.
Set performance expectations and hold the team accountable for field KPIs, service levels, customer engagement measures, and business objectives; use performance data to identify trends and address gaps.
Meet Senior Manager field-time and coaching expectations and maintain regional field presence to observe customer engagement, coach FRMs, assess market dynamics, and understand the customer access experience.
Ensure consistent, compliant customer access support through reimbursement expertise, responsive engagement, issue resolution, and appropriate follow-through.
Develop and execute regional strategies that translate national access priorities into territory and account plans using payer, account, market, competitive, channel, and performance insights.
Coach FRMs on account management, analytical reasoning, fact-based decision-making, account prioritization, resource allocation, and account-specific access strategies.
Maintain expertise in Specialty Pharmacy and Buy & Bill reimbursement and build team capability to support a dual-benefit product model.
Monitor payer dynamics, reimbursement policy, competition, channel trends, reimbursement economics, and stakeholder practices; translate insights into regional strategy and execution.
Lead compliant collaboration with Sales, Key Account Management, Market Access, Medical, HUB, Operations, Training, and other partners to align priorities, resolve barriers, and improve customer experience.
Lead regional business reviews and performance discussions, establish actions, and ensure follow-through.
Identify, escalate, and help resolve systemic access, reimbursement, process, and operational issues; communicate insights and recommendations to leaders and partners.
Ensure team compliance with business rules, policies, procedures, privacy requirements, and field reimbursement rules of engagement through coaching, observations, virtual engagement, and performance management.
Partner with Training and Capability Development to identify skill gaps, support onboarding, reinforce reimbursement and account-management capabilities, and advance team development.
Drive operational excellence through regional planning, resource prioritization, expense management, CRM adoption, timely documentation, escalation management, and consistent process execution.
Hire and onboard talent, build succession and development plans, and empower team members to grow, take ownership, and deliver results.
Influence across a complex matrix organization, building trusted relationships and aligning stakeholders around access priorities and customer needs.