Field Reimbursement Manager

Less than 5 years experience  •  Healthcare IT

Salary depends on experience
Posted on 11/05/17
Columbia, SC
Less than 5 years experience
Healthcare IT
Salary depends on experience
Posted on 11/05/17

Responsibilities
The Field Reimbursement Manager will be responsible for the management of defined accounts in a specified geographic region in the Immunology & Dermatology therapeutic area, specifically supporting our clients product in the targeted dermatology market. The Field Reimbursement Manager will execute the collaborative territory strategic plan through partnership with internal and external stakeholders, including call center services and other collaboration partners. Responsibilities include ensuring understanding of Reimbursement services and program support as it relates to the Immunology & Dermatology franchise. The Reimbursement Manager will also work on patient level reimbursement issue resolution, and thus will need access to be knowledge of and have had experience with patient health information (PHI). Note this is not a sales job.
 

Services and Activities Provided by Reimbursement Managers:

  • Field Reimbursement Managers manage daily activities that support appropriate patient Reimbursement to our client's products in the provider offices and work as a liaison to other patient assistance and Reimbursement support services offered by our client. Activities include, but are not limited to:
  • Provide live one-on-one support to address questions about coverage requirements
  • Offer assistance from prescriber decision through to access, supporting the entire Reimbursement journey through payer prior authorization to appeals/denials requirements procedures and forms
  • Reviewing patient-specific information in cases where the site has specifically requested the assistance and patient health information is available in resolving any issues or coverage challenges
  • Reviewing patient insurance benefit options, in cases where patient health information is available as a result of patient SRF
  • Coordinating with other patient support service program representatives and with the field sales force, if necessary
  • Educating physician office staff on the use of the patient assistance programs and call center support services, including web based provider programs
  • Provide information on relevant Reimbursement topics related to the client product
  • Serve as payer expert for defined geography and able to communicate changes to key stakeholders in a timely manner



Requirements

  • Bachelor's degreerequired or relevant specific industry management experiencepreferred
  • Minimum three years' experience in public or private third party Reimbursement arena or pharmaceutical industry in managed care, clinical support, or sales.
  • Experience with specialty products acquired through Specialty Pharmacy networks
  • Experience with coding, billing and in office support programs
  • Specialty pharmacy experiencerequired (ability to teach an office the entire process from script to injection)
  • Establishing relationships within a practice by working closely with them to help remove Reimbursement barriers to specialty products for their patients
  • Ability to operate as a "team player" in collaborating with multiple sales representatives, sales leadership, and internal colleagues to reach common goals
  • Knowledge of Centers of Medicare & Medicaid Services (CMS) policies and processes with expertise in Medicare Part D (Pharmacy Benefit design and coverage policy) a plus
  • Knowledge of Managed Care, Government, and Federal payer sectors, as well as Integrated Delivery Network/Integrated Health Systems a plus
  • Ability to travel and cover large multistate geography territories, at least 50% travelrequired, based on geography and territory / targeting make up
  • Excellent presentation skills
  • Advanced knowledge of medical insurance terminology
  • Strong teamwork abilities
  • Project management skills
  • Ability to work independently
  • Ability to manage expenses within allocated budgets
  • Good driving record
  • Ability to schedule individual work related travel (air, hotel, rental car as needed)
  • Above average computer skills: PowerPoint, Excel, Word, CRM (Salesforce.com)
  • Understanding of patient privacy laws including HIPAA and similar state laws
  • Strong business acumen
  • Ability to travel and possess a valid driver's license to drive to assigned healthcare accounts, unless otherwise specified

 

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