Field Reimbursement Specialist Senior Manager - West - Los Angeles CA

VetJobs•Los Angeles, CA

6d•$176,905 - $239,341•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 access to Tezspire in the Respiratory therapeutic area. The role builds and coaches a high-performing team, translates national and regional priorities into effective field execution, and promotes accountability, collaboration, inclusion, and positive momentum. The Senior Manager is accountable for team performance against field KPIs and service expectations, including personal and team field-time measures, while ensuring an excellent, compliant access experience for customers and patients. The position uses payer, account, market, competitive, channel, and performance insights to guide regional strategy, develop FRM capabilities, and address access barriers across Specialty Pharmacy and Buy & Bill channels. It includes field coaching and observations, regional business reviews, cross-functional collaboration, compliance oversight, operational planning, and talent development.

Requirements

One of the following education and experience combinations in a public or private third-party access arena or pharmaceutical industry in sales, managed care, or clinical support: doctorate degree and 2 years; master's degree and 4 years; bachelor's degree and 6 years; associate's degree and 10 years; or high school diploma/GED and 12 years.

Nice To Haves

Bachelor's degree in business, healthcare, or a related field.
Five years of experience as a manager or first-line leader, or demonstrated people leadership involving coaching, development, motivation, and performance management.
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.
Expertise in Specialty Pharmacy and Buy & Bill reimbursement, including prior authorization, appeals and denials, coding, billing, claims, benefit design, and patient support programs.
Understanding of commercial payer, Medicare, and Medicaid access and reimbursement dynamics and ability to translate payer policy changes into field action.
Experience leading and coaching account management, business planning, and customer engagement in a field-based reimbursement organization.
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.
Cross-functional leadership and collaboration skills, including the ability to influence outcomes in a complex matrix organization.
Commitment to ethical, legal, and compliance standards and experience leading teams within field reimbursement rules of engagement.
Presentation, facilitation, coaching, and communication skills for working with field teams, customers, partners, and senior leadership.
Organizational and project management skills, including managing priorities, leading change, and ensuring timely follow-through.
Experience with CRM and performance-management tools to monitor field execution, identify trends, and support coaching and business decisions.
Healthcare industry experience, including physician offices or clinics, specialty pharmacy, HUB services, insurance verification, claim adjudication, or pharmaceutical/biotechnology manufacturers.
Experience leading a field reimbursement team supporting specialty pharmaceutical or biologic products and/or launching products or indications.
Advanced experience with dual-benefit products and 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 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 grounded in accountability, collaboration, inclusion, trust, and positive momentum, reinforcing Amgen Values and expected leadership behaviors.
Set performance expectations and hold the team accountable for field KPIs, service expectations, customer engagement measures, and business objectives.
Meet Senior Manager field-time and coaching expectations and maintain appropriate field presence to observe customer engagement, coach FRMs, assess market dynamics, and stay connected to customer access experiences.
Ensure the team delivers a high-quality access experience through reimbursement expertise, responsive engagement, issue resolution, follow-through, and compliant execution.
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 decisions, account prioritization, and adapting execution based on performance and market insights.
Maintain expertise across Specialty Pharmacy and Buy & Bill reimbursement and develop 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 cross-functional collaboration with Sales, Key Account Management, Market Access, Medical, HUB, Operations, Training, and other partners to align access priorities and resolve barriers.
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 leadership and partners.
Ensure 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 promote continuous development.
Drive operational excellence through regional planning, resource prioritization, expense management, CRM adoption, timely documentation, escalation management, and consistent processes.
Hire and onboard talent, build succession and development plans, and empower team members to take ownership and deliver results.
Influence across a complex matrix organization, building trusted relationships and aligning stakeholders around access priorities and customer needs.