Field Reimbursement Manager (Southern California)

United Statesmid

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),

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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 (i.e. HUB, Call Center, Specialty Pharmacy Services).
→Act as an extension of client’s HUB, as appropriate and provide in-person customer visits.
→Participate in client meetings as appropriate. Participate in regularly scheduled team 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, insurance forms & procedures, benefits investigation, prior authorization, appeal, and/or claims resolution.
→Educate offices using approved educational materials provided by the client.
→Review specific patient case information, in a compliant manner, defined by the client.
→Educate physician office staff on the use of our client’s patient support services, including web-based provider portals.

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
Ability to travel 3-4 days a week, with overnights and flights (as needed), must reside within the territory
Solution oriented mindset, strong business acumen, & strong analytic capabilities
Experience with specialty/biologic products and/or complex reimbursement process
Demonstrated ability to educate offices on access processes and issue resolution
Experience educating HCPs on client specific Patient Service programs (i.e. copay, nurse education, bridge, patient assistance, etc.)
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 B – for buy & bill products and Part D for Pharmacy products)
Ability to manage ambiguity & problem solve
Prepare and submit appropriate expense reports in a timely fashion
Valid Driver’s License