Field Reimbursement Manager - Allentown, PA

Amgen • Philadelphia, PA

3d • $145,471 - $196,813 • Remote

About The Position

The Field Reimbursement Manager (FRM) manages defined accounts in a specified geographic region and supports Patient Access and Reimbursement for Amgen’s 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 resolves patient-level reimbursement issues and requires knowledge of patient health information (PHI).

The FRM acts as an extension of the HUB, providing one-on-one coverage support throughout the reimbursement journey—from physician order and payer prior authorization through appeals, denials, and claims resolution. The role educates healthcare providers about payer coverage, benefit design, formulary and utilization-management criteria, insurance procedures, benefits investigations, and patient funding or financial-assistance options. The FRM reviews patient-specific information when a site requests help with coverage challenges, coordinates issues with the HUB and other partners, monitors payer changes in the assigned geography, and collaborates across departments to resolve reimbursement issues.

The position covers Eastern and Central Pennsylvania, excluding Philadelphia. The employee should live in the geography or within 10 miles of its border. The work is remote from a home office, 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. 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; associate's degree and 10 years; or high school diploma/GED and 12 years.
• In addition to one of the listed education and experience combinations, have experience directly managing people and/or leadership experience leading teams, projects, or programs, or directing resource allocation. This experience may run concurrently with required technical experience.
• At least 2 years of experience in a public or private third-party access arena or the pharmaceutical industry in managed care, clinical support, and/or sales.
• Strong medical reimbursement experience and/or knowledge of Specialty Pharmacy and Buy & Bill.
• Proven presentation and facilitation skills.
• Strong written and oral communication skills.
• Organizational and project management skills, including the ability to manage multiple projects.
• Strong computer literacy, including Word, Excel, PowerPoint, and web-based meetings.
• Healthcare industry experience, including insurance verification, claims 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 (pharmacy benefit) 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 a specified 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 required forms.
• Review patient-specific information when a site requests assistance resolving reimbursement or coverage issues.
• 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 promptly communicate payer changes to stakeholders.
• Provide office education on formulary coverage, utilization-management criteria, insurance forms and procedures, benefits investigations, prior authorization, appeals, and claims resolution.
• Educate offices using approved materials.
• Review patient insurance benefit options and alternative funding or financial-assistance programs.
• Collaborate with other departments and cross-functional partners to resolve reimbursement issues.

Benefits

• Health and welfare plans for staff and eligible dependents.
• 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.

What This Job Offers

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