The Field Reimbursement Manager (FRM) is responsible for managing an assigned territory focused on supporting reimbursement and patient access by providing assistance with patient reimbursement challenges for a specific drug (including Benefit Investigation, Prior Authorization, Claims Assistance, and Appeals) and educating the office on Payer landscape and services available through both remote interaction and on-site training. This position is client-facing and customer-facing and requires the ability to build relationships with physician offices as well as manufacturer representatives to effectively deliver services based on customer specific preferences. The Field Reimbursement Manager works independently in a fast paced, highly visible environment as well as collaboratively with the internal program hub support services to ensure all customer needs are met. FRM will frequently interact via telephone with providers and internal staff to arrange site visits, Manufacturer trainings, and educational training venues. Must have a solid working knowledge of Medicare and Commercial insurance plans and benefit structures in order to relay detailed benefit information and maximize the customer experience. Position will require travel, project management and/or account coordination based on client expectation.
Key Responsibilities (List the top five to seven essential responsibilities in priority order.)
Provide on-site and on-demand education for the office staff in regard to reimbursement challenges and support services that are available. Office interaction will include education and reimbursement support. On-site Face to Face interactions will average 5 interactions per day x 3
days per week. Virtual Interactions will average 5 interactions per day x 2 days per week. These activities are recorded in FRM CRM daily with reporting to manager and client weekly.
Educate on Benefit Investigation, Prior Authorization Process, Support Center Services, Medicare and Commercial coverage and patient communication streams. Monthly activity reporting captures educational topics at FRM level reportable to client based on client expectation. This trended data is also reported quarterly regularly to client.
Reimbursement support, account management, billing and coding updates, appropriate claims submission, Retail Pharmacy/Specialty Pharmacy, Medical Benefit Interpretation, understanding medical necessity, claims and appeal assistance, information related to co-pay assistance programs. FRM will collaborate with multiple stakeholders ensuring all parties are aligned to resolutions and outcomes.
Responsible for setting up appointments and completing virtual and/or outbound calls to provider offices. Additional day-to-day in-office work. Interface with physicians to obtain and provide patient and payer specific information. All FRM interactions/activities are tracked in FRM CRM which are reportable to management and client.
Monitor program performance for physicians and manufacturer representatives in accordance with expectations. Territory performance will be monitored via FRM CRM dashboard daily. Trending results will be identified through regular reporting. Additionally, clients have the option to survey customers on program performance.
Research and compile provider / manufacturer representative specific information for reimbursement database. (Includes account profiles) FRM will create a facility database on each new provider in FRM CRM. All interactions/activities are built utilizing this database.
100%
Minimum Job Qualifications (Knowledge, Skills, & Abilities):
Education/Training -
4-year degree in related field or equivalent experience.
Business Experience -
Field Reimbursement experience preferred
HCP facing field experience (i.e. Field Reimbursement, sales, market access) highly preferred
Entry-level experience in project management
Minimum of 5 years healthcare related reimbursement experience with a balance on the HCP facing experience
Strong experience with Buy & Bill, Retail, and/or Specialty Pharmacy
Experience in the healthcare industry including, but not limited to insurance verification, prior authorizations, and/or claim adjudication, physician's office or clinics.
Must have Medicare and commercial insurance coverage experience.
Must be able to speak to benefit investigation outcomes and relay status reports on a regular basis.
Strong customer service and problem resolution experience
Proven presentation skills and experience
Ability to effectively handle multiple priorities within a changing environment.
Excellent organizational skills
Strong Computer literacy to include PowerPoint and Web Meeting experience
Specialized Knowledge/Skills -
Previous field experience, a plus
Previous experience with retail pharmacy a plus
Account management experience, a plus
Excellent Interpersonal skills.
Excellent written and oral communication skills
Problem solving and decision-making skills
Working Conditions:
General Office Demands - Remote, WFH when not traveling
Travel Requirements
Must reside in territory
Must be able to travel 60% (3 days a week) via automobile or plane
Must have a valid driver's license with a clean driving record/ MVR
Physical Requirements (Lifting, standing, etc.) -
Possible long periods of sitting and/or keyboard work. General office demands.
We are proud to offer a competitive compensation package at McKesson as part of our Total Rewards. This is determined by several factors, including performance, experience and skills, equity, regular job market evaluations, and geographical markets. The pay range shown below is aligned with McKesson's pay philosophy, and pay will always be compliant with any applicable regulations. In addition to base pay, other compensation, such as an annual bonus or long-term incentive opportunities may be offered. For more information regarding benefits at McKesson, please click here.
Our Base Pay Range for this position
$88,300 - $147,100
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