Career CategorySales & Marketing Operations
Job DescriptionField Reimbursement Manager, Miami, FLWhat you will doLet's do this. Let's change the world. In this vital role the Field Reimbursement Manager (FRM) will manage defined accounts within a specified geographic region for Patient Access and Reimbursement. This role involves supporting products by executing the collaborative territory strategic plan. The FRM will ensure an understanding of the reimbursement process, field reimbursement services, and patient support programs. They will also work on patient-level reimbursement issue resolution, requiring knowledge and experience with patient health information (PHI).
- Act as an extension of the HUB, providing live one-on-one coverage support
- Offer assistance from physician order to reimbursement, supporting the entire reimbursement journey through payer prior authorization to appeals/denials requirements and forms
- Review patient-specific information in cases where the site has specifically requested assistance resolving any issues or coverage challenges
- Educate and update healthcare providers (HCPs) on key private and public payer coverage and changes that impact patient product access
- Coordinate access/reimbursement issues with relevant partners, including the HUB
- Provide information to HCPs on how the products are covered under the benefit design (Commercial, Medicare, Medicaid)
- Serve as a payer expert for defined geography and promptly communicate payer changes to key stakeholders
- Offer office education during the access process, including formulary coverage/utilization management criteria, insurance forms & procedures, benefits investigation, prior authorization, appeal, and/or claims resolution
- Educate offices using approved materials
- Review patient insurance benefit options and alternate funding/financial assistance programs
- Collaborate with other departments to resolve reimbursement issues
Working Conditions:- 3 days a week in geography for customer appointments, (geography specific)
- General office demands - Remote, Work from Home.
- One to two home office days per week.
- Must be able to travel up to 60-80% via automobile or plane.
- Must have a valid driver's license with a clean driving record.
- Possible long periods of sitting and/or keyboard work.
What we expect of youWe are all different, yet we all use our unique contributions to serve patients. The field reimbursement professional we seek has these qualifications.
Basic Qualifications:Doctorate degree
OR
Master's degree and 3 years of customer service and/or leadership experience
OR
Bachelor's degree and 5 years of customer service and/or leadership experience
OR
Associate's degree and 10 years of customer service and/or leadership experience
OR
High school diploma / GED and 12 years of customer service and/or leadership experience
In addition to meeting at least one of the above requirements, you must have experience directly managing people and/or leadership experience leading teams, projects, programs, or directing the allocation or resources. Your managerial experience may run concurrently with the required technical experience referenced above
Preferred Qualifications:- Bachelor's degree in business, healthcare, or a related field
- 6 years' experience with specialty/biologic self-injectable (pharmacy benefit) or physician-administered (buy and bill/medical benefit) products
- Bilingual proficiency in English and Spanish, with the ability to communicate effectively in both languages
- 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 and problem-solve
- Ability to manage expenses within allocated budgets
- Strong medical reimbursement experience and/or Specialty Pharmacy and Buy & Bill knowledge
- Proven presentation and facilitation skills
- Strong written and oral communication skills
- Organizational skills and project management experience, including the ability to manage multiple projects
- Strong computer literacy, including Word, Excel, and PowerPoint, and the ability to conduct web-based meetings
- Experience in the healthcare industry, including insurance verification, claim adjudication, physician's offices or clinics, pharmacies, and/or pharmaceutical manufacturers
What you can expect from usAs we work to develop treatments that take care of others, we also work to care for your professional and personal growth and well-being. From our competitive benefits to our collaborative culture, we'll support your journey every step of the way.
The expected annual salary range for this role in the U.S. (excluding Puerto Rico) is posted. Actual salary will vary based on several factors including but not limited to, relevant skills, experience, and qualifications.
In addition to the base salary, Amgen offers a Total Rewards Plan, based on eligibility, comprising of health and welfare plans for staff and eligible dependents, financial plans with opportunities to save towards retirement or other goals, work/life balance, and career development opportunities that may include:
- A comprehensive employee benefits package, including a Retirement and Savings Plan with generous company contributions, group medical, dental and vision coverage, life and disability insurance, and flexible spending accounts
- A discretionary annual bonus program, or for field sales representatives, a sales-based incentive plan
- Stock-based long-term incentives
- Award-winning time-off plans
- Flexible work models where possible. Refer to the Work Location Type in the job posting to see if this applies.
Salary Range145,470.70USD -196,813.30 USD
