Field Reimbursement Manager

McKesson•Omaha, IA

18h•Onsite

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. The company fosters a culture where employees can grow, make an impact, and are empowered to bring new ideas. The Field Reimbursement Manager (FRM) manages an assigned territory, supporting Reimbursement and Patient services by assisting with patient reimbursement challenges for a specific drug, including Benefit Investigation, Prior Authorization, Claims Assistance, and Appeals. The role also involves educating offices on the Payer landscape and available services through remote interaction and on-site training. This client-facing and customer-facing position requires building relationships with physician offices and manufacturer representatives to deliver services based on customer preferences. The FRM works independently in a fast-paced, highly visible environment, collaborating with internal program hub support services. Frequent telephone interaction with providers and internal staff is required to arrange site visits, manufacturer trainings, and educational venues. A solid working knowledge of Medicare and Commercial insurance plans and benefit structures is essential to relay detailed benefit information. The position requires travel, project management, and/or account coordination based on client expectations.

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 office staff regarding Reimbursement challenges and available support services.
Conduct office interactions, including education and reimbursement support, averaging 15 on-site/virtual interactions per week, recorded daily in FRM CRM with weekly reporting to manager.
Educate on Benefit Investigation, Prior Authorization Process, Support Center Services, Medicare and Commercial coverage, and patient communication streams.
Ensure monthly activity reporting captures educational topics at the FRM level, reportable to the client based on client expectation, with trended data reported quarterly.
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, and information related to co-pay assistance and patient assistance programs.
Collaborate with case managers on average 4 times per month and ad hoc for escalations, tracking interactions in FRM CRM and the hub system.
Set up appointments and complete outbound calls to targeted offices.
Assist in completing backlog casework.
Perform additional day-to-day in-office work.
Interface with physicians and manufacturer representatives to obtain and provide patient and provider specific information, tracking all interactions/activities in FRM CRM for management and client reporting.
Monitor program performance for physicians and manufacturer representatives in accordance with expectations, tracking territory performance daily via FRM CRM dashboard and identifying trending results through quarterly reporting.
Research and compile provider / manufacturer representative specific information for the reimbursement database, including account profiles.
Create a facility database on each new provider in FRM CRM, utilizing this database for all interactions/activities.