Field Reimbursement Manager

McKesson•Work at Home - District of Columbia, USA (WDCA), VA

1d•$92,300 - $153,900•Remote

About The Position

The CoverMyMeds Field Reimbursement Manager manages an assigned territory and supports reimbursement and patient services for a specific drug. The role assists with patient reimbursement challenges, including benefit investigations, prior authorizations, claims assistance, and appeals, and educates physician-office staff about payer landscapes and available services through remote interaction and on-site training. It is client-facing and customer-facing, requiring relationship-building with physician offices and manufacturer representatives and the ability to tailor service delivery to customer preferences. The manager works independently in a fast-paced, highly visible environment and collaborates with internal program hub support services to meet customer needs. The role frequently uses telephone communication to arrange site visits, manufacturer trainings, and educational venues, and requires working knowledge of Medicare and commercial insurance plans and benefit structures. Travel, project management, and/or account coordination may be required based on client expectations. The position is remote, work from home, but the employee must reside in the assigned territory and travel approximately 80% (four days a week) by automobile or plane. Compensation is a base pay range of $92,300–$153,900; annual bonus or long-term incentive opportunities may also be offered.

Requirements

Four-year degree in a related field or equivalent experience.
At least four years of healthcare-related reimbursement experience.
Strong medical reimbursement experience with Buy & Bill and/or specialty pharmacy.
Healthcare-industry experience, including insurance verification, prior authorizations, and/or claim adjudication in a physician's office or clinic.
Experience with Medicare and commercial insurance coverage.
Ability to deliver and document benefit-investigation outcomes and relay status reports regularly.
Proven presentation skills and experience.
Ability to handle multiple priorities effectively and strong organizational skills.
Strong computer literacy, including PowerPoint and web-meeting experience.
Excellent interpersonal skills and written and oral communication skills.
Problem-solving and decision-making skills.
Must reside in the territory and be able to travel 80% (four days a week) by automobile or plane.
Valid driver's license and clean driving record/MVR.

Nice To Haves

Previous field experience.
Previous specialty pharmacy experience.
Account management experience.

Responsibilities

Provide on-site and on-demand education, including lunch-and-learns and dinner presentations, about reimbursement challenges and available support services; average 15 on-site or virtual interactions per week and record activities in the FRM CRM daily, with weekly reporting to the manager.
Educate offices on benefit investigations, prior authorization processes, Support Center services, Medicare and commercial coverage, and patient communication streams; report educational topics monthly and provide trended data to clients quarterly.
Provide reimbursement support for case management, billing and coding updates, claims submission, specialty pharmacy, medical-benefit interpretation, medical necessity, claims and appeals, co-pay assistance, and patient assistance programs.
Collaborate with case managers, averaging four interactions per month and additional interactions as needed for escalations; track interactions in the FRM CRM and hub system.
Set up appointments, complete outbound calls to targeted offices, assist with backlog casework, and perform other day-to-day in-office work.
Interface with physicians and manufacturer representatives to obtain and provide patient- and provider-specific information; track all interactions and activities in the FRM CRM for management and client reporting.
Monitor program performance for physicians and manufacturer representatives against expectations, use the FRM CRM dashboard to monitor territory performance daily, and identify trends for quarterly reporting.
Research and compile provider- and manufacturer-representative-specific reimbursement information, including account profiles, and create a facility database for each new provider in the FRM CRM.