Career CategoryCorporate Services
Job DescriptionMust live in territory.What 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.
WinWhat we expect of you We are all different, yet we all use our unique contributions to serve patients. The field reimbursement professional we seek is a collaborator with these qualifications.
Basic Qualifications: Doctorate degree
OR
Master's degree and 3 years of patient services, and/or access and reimbursement, experience in the pharma space.
OR
Bachelor's degree and 5 years of patient services, and/or access and reimbursement, experience in the pharma space.
OR
Associate's degree and 10 years of patient services, and/or access and reimbursement, experience in the pharma space.
OR
High school diploma / GED and 12 years of patient services, and/or access and reimbursement, experience in the pharma space.
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
Minimum Job Qualifications: - Minimum two years of experience in public or private third-party access arena or pharmaceutical industry in managed care, clinical support, and/or sales
- 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
- Proven experience with hubs and in-depth knowledge of issues related to billing, coding, and appeals across physician types
- Strong collaboration and ability to lead cross functional partner meetings
- Experience with commercial payers, Medicare plans, and state Medicaid in a geographic region
- Live in the geography or less than 10 miles from the geography border
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
- 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
ThriveWhat you can expect of usAs we work to develop treatments that take care of others, we also work to care for our teammates' professional and personal growth and well-being.
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.
Amgen offers a Total Rewards Plan comprising 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 including:
- 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 and bi-annual company-wide shutdowns
- Flexible work models, including remote work arrangements, where possible
Apply now for a career that defies imagination Objects in your future are closer than they appear. Join us.
careers.amgen.comAmgen's application deadline is 8/10 for this position; we will continue accepting applications until we receive a sufficient number or select a candidate for the position.
Salary Range145,470.70USD -196,813.30 USD
