Field Reimbursement Manager - Oklahoma City, OK

Amgen • Oklahoma City, OK

1d • $145,471 - $196,813 • Remote

About The Position

The Field Reimbursement Manager (FRM) manages defined accounts in Oklahoma for Patient Access and Reimbursement and supports the Bone Health business unit. The role executes a collaborative territory strategic plan and helps healthcare providers understand reimbursement processes, field reimbursement services, and patient support programs. It addresses patient-level reimbursement issues and may involve handling patient health information when a site specifically requests assistance with coverage challenges.

The FRM acts as an extension of the HUB, providing one-on-one support across the reimbursement journey, from physician order through payer prior authorization, appeals, denials, and claims resolution. The role educates healthcare providers about payer coverage and changes, benefit design, formulary coverage, utilization management, insurance procedures, benefits investigations, and financial assistance options. It coordinates access and reimbursement issues with relevant partners and serves as a payer expert for the assigned geography.

The position is remote and home-based, with customer appointments in the territory two days per week and one to two home-office days per week. Travel of up to 40% by car or plane is required. 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 of customer service and/or leadership experience; associate's degree and 10 years of customer service and/or leadership experience; or high school diploma/GED and 12 years of customer service and/or leadership experience.
• 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 a public or private third-party access arena or pharmaceutical industry in managed care, clinical support, and/or sales.
• Strong medical reimbursement experience and/or Specialty Pharmacy and Buy & Bill knowledge.
• Proven presentation and facilitation skills.
• Strong written and oral communication skills.
• Organizational skills and project management experience, including the ability to manage multiple projects.
• Computer literacy, including Word, Excel, PowerPoint, and web-based meetings.
• Healthcare industry experience in areas such as insurance verification, claim adjudication, physician offices or clinics, pharmacies, and/or pharmaceutical manufacturers.
• 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 assigned geography or within 10 miles of its border.
• Valid driver's license with a clean driving record.
• Ability 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 or biologic self-injectable pharmacy-benefit products or physician-administered Buy & Bill/medical-benefit products.
• Advanced knowledge of medical insurance terminology.
• Knowledge of Centers for Medicare & Medicaid Services (CMS) 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 the assigned 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.
• Support the reimbursement journey from physician order through prior authorization, appeals, denials, and claims resolution.
• Review patient-specific information when a site requests help resolving reimbursement or coverage issues.
• Educate and update healthcare providers on private and public payer coverage and changes affecting 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.
• Provide office education 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

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

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Education Level: No Education Listed