Field Reimbursement Manager - Birmingham, AL

Amgen•Montgomery, AL

1d•Remote

About The Position

The Field Reimbursement Manager (FRM) manages defined accounts within a specified geographic region for Patient Access and Reimbursement, supporting 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 also involves resolving patient-level reimbursement issues and handling patient health information (PHI) when needed. The territory covers Alabama and the eastern half of Mississippi. Relocation is not included. The FRM acts as an extension of the HUB, providing live, one-on-one coverage support throughout the reimbursement journey, from physician orders through payer prior authorization, appeals, denials, and claims resolution. The role educates healthcare providers on payer coverage, benefit design, formulary and utilization-management criteria, insurance procedures, benefits investigations, and financial assistance options. The FRM serves as a payer expert for the assigned geography and coordinates with the HUB and other partners to resolve access and reimbursement issues. The position is remote and work from home, 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 automobile or plane is required. The role may involve prolonged sitting and keyboard work, and requires a valid driver's license with a clean driving record.

Requirements

Doctorate degree; or a master's degree and 3 years of customer service and/or leadership experience; or a bachelor's degree and 5 years; or an associate's degree and 10 years; or a high school diploma/GED and 12 years.
In addition to one of the education and experience combinations above, experience directly managing people and/or leadership experience leading teams, projects, or programs, or directing resource allocation.
At least 2 years of experience in public or private third-party access or the 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, and PowerPoint, and the ability to conduct web-based meetings.
Healthcare-industry experience involving 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.
Must have a valid driver's license with a clean driving record.
Must be able 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/biologic self-injectable products (pharmacy benefit) or physician-administered products (buy and bill/medical benefit).
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-and-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 in an assigned geographic region for Patient Access and Reimbursement.
Support products by executing the collaborative territory strategic plan.
Act as an extension of the HUB by providing live, one-on-one coverage support.
Assist healthcare providers from physician order through reimbursement, including prior authorization, appeals, denials, and claims resolution.
Review patient-specific information when a site requests help resolving an issue or coverage challenge.
Educate and update healthcare providers on private and public payer coverage and changes affecting patient 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

Competitive benefits supporting professional and personal growth and well-being.
Retirement and Savings Plan with generous 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.
Award-winning time-off plans.
Flexible work models where possible.
Career development opportunities.