Field Reimbursement Manager

McKesson•Usa, AZ

10h•Remote

About The Position

The CoverMyMeds Field Reimbursement Manager (FRM) 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 offices about payer landscapes and available services through remote interactions and on-site training. It is a client-facing and customer-facing position that builds relationships with physician offices and manufacturer representatives to deliver services according to customer preferences. The FRM works independently in a fast-paced, highly visible environment and collaborates with internal program hub support services to meet customer needs. The role frequently communicates by telephone with providers and internal staff to arrange site visits, manufacturer trainings, and educational venues. It requires working knowledge of Medicare and commercial insurance plans and benefit structures. Travel, project management, and account coordination are required based on client expectations. The position is remote and work-from-home, with the employee required to reside in the assigned territory and travel approximately 80% (four days per week) by automobile or plane. Work may involve long periods of sitting and/or keyboard use. The listed base pay range is $80,300–$133,800. An 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, claims adjudication, or work in a physician’s office or clinic.
Experience with Medicare and commercial insurance coverage.
Ability to deliver and document benefit investigation outcomes and regularly relay status reports.
Proven presentation skills and experience.
Ability to handle multiple priorities effectively and strong organizational skills.
Computer literacy, including PowerPoint and web meeting experience.
Excellent interpersonal skills and excellent written and oral communication skills.
Problem-solving and decision-making skills.
Must reside in the assigned territory.
Ability to travel 80% (four days a week) by automobile or plane.
Valid driver's license with a 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 or Dinner presentations, about reimbursement challenges and available support services.
Conduct an average of 15 on-site or virtual interactions per week, record activities in the FRM CRM daily, and report to the manager weekly.
Educate office staff about benefit investigations, prior authorization processes, Support Center services, Medicare and commercial coverage, and patient communication streams.
Provide reimbursement support for case management, billing and coding updates, claims submission, specialty pharmacy, medical benefit interpretation, medical necessity, claims and appeals, copay assistance, and patient assistance programs.
Collaborate with case managers an average of four times per month and as needed for escalations, tracking 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 FRM interactions and activities in the CRM for reporting to management and clients.
Monitor program and territory performance using the FRM CRM dashboard, identify trends for quarterly reporting, and support customer surveys when clients choose to conduct them.
Research and compile provider- and manufacturer representative-specific reimbursement information, including account profiles, and create a facility database entry for each new provider in the FRM CRM.