Field Reimbursement Manager (New England)

Field Basedmid

OtherField Reimbursement Manager

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Quick Summary

Requirements Summary

3+ years of experience in one or more of the following areas: Managed Care, Field Reimbursement, Patient Services, and/or Sales (Specialty or Biologics),

Technical Tools

OtherField Reimbursement Manager

Responsibilities

~1 min read

→Manage daily activities that support appropriate patient access to our client’s products in the provider offices and work as a liaison to other patient assistance and access support services offered by our clients.
→Expert in providing general education on Retail and Specialty Pharmacy drug Prior Authorizations, Appeals, and Denials
→Provide in-person customer visits.
→Participate in client meetings as appropriate. Participate in regularly scheduled internal team and cross-functional meetings and calls. Input call activity into customer CRM, as appropriate.
→Serve as payer expert for defined geography and able to communicate payer changes to key stakeholders in a timely manner.
→Provide office education and awareness during the entire access process which may include formulary coverage/utilization management criteria, coding, insurance forms & procedures, benefits investigation, prior authorization, appeal, and/or claims resolution.
→Educate offices using approved educational materials provided by the client.

Requirements

~1 min read

3+ years of experience in one or more of the following areas: Managed Care, Field Reimbursement, Patient Services, and/or Sales (Specialty or Biologics), or healthcare provider office practice management
4-year degree in related field or equivalent experience
Cardiovascular/Cardiology and Hospital Healthcare Systems experience a plus
The ability to travel 3-4 days a week, with overnights (as needed), must reside within the Territory
Solution oriented mindset, strong business acumen, & strong analytic capabilities
Experience and understanding of Retail Pharmacies & Specialty Pharmacies
Demonstrated ability to educate offices on access processes and issue resolution
Experience educating HCPs and office staff on client specific Patient Service programs (i.e. copay)
Experience delivering educational presentations in person and/or via technology platforms such as Zoom, Webex, and/or Teams
Advanced knowledge of medical insurance terminology
Knowledge of Centers of Medicare & Medicaid Services (CMS) policies and processes with expertise in Medicare (Part D for Pharmacy Benefit products)
Proven ability to develop and maintain trusted relationships with internal partners and effectively work well in teams
Ability to manage ambiguity & problem solve
Prepare and submit appropriate expense reports in a timely fashion
Valid Driver’s License