The Senior Manager, Field Reimbursement Operations serves as the first-line leader for a team of Field Reimbursement Managers (FRMs), providing operational oversight, coaching, performance management, and strategic support while maintaining a limited portfolio of key provider accounts when appropriate. This role is responsible for ensuring the consistent execution of client program objectives, reimbursement excellence, and exceptional customer service across assigned therapeutic areas.
The Senior Manager, Field Reimbursement Operations partners closely with the Senior Director, Operations, Training, Quality, Analytics, and Client Program Leadership to drive program performance, ensure compliance, and deliver best-in-class reimbursement support for healthcare providers.
Team Leadership- Provide day-to-day leadership and oversight for an assigned team of Field Reimbursement Managers.
- Coach, mentor, and develop FRMs through regular one-on-one meetings, field observations, ride-alongs, and performance feedback.
- Foster a culture of accountability, collaboration, professionalism, and continuous improvement.
- Conduct new hire onboarding and assist with ongoing development plans.
- Assist in interviewing and selecting new team members.
- Manage employee performance, including recognition, coaching, corrective action, and performance improvement plans.
- Promote employee engagement and retention through consistent leadership and communication.
Operational Leadership- Ensure consistent execution of client-approved reimbursement services.
- Monitor daily program activities and workload distribution.
- Review reimbursement trends and identify barriers requiring escalation.
- Partner with Operations to optimize workflows and improve efficiencies.
- Ensure documentation is timely, accurate, and compliant within all CRM platforms.
- Support implementation of new initiatives and operational enhancements.
Client Partnership- Serve as an escalation point for complex reimbursement challenges.
- Participate in client meetings, business reviews, and strategic planning sessions.
- Build strong relationships with client leadership and internal cross-functional partners.
- Support implementation of new product launches and program expansions.
- Assist with Quarterly Business Reviews (QBRs), monthly reporting, and client presentations.
Field LeadershipConduct routine field travel with FRMs or virtual as required to provide coaching and ensure execution consistency.
Observe provider interactions and provide immediate developmental feedback.
Identify reimbursement trends impacting provider offices.
Reinforce standardized messaging and approved reimbursement education.
Performance Management- Monitor key performance indicators including:
- Productivity
- CRM documentation quality
- Case progression
- Provider engagement
- Activity metrics
- Quality measures
- Client-specific KPIs
- Develop action plans for performance improvement when needed.
- Recognize high-performing employees and share best practices across the organization.
Training & Development- Reinforce reimbursement knowledge across assigned therapeutic areas.
- Partner with Training to identify knowledge gaps.
- Assist in development of training materials.
- Conduct ongoing competency assessments.
- Facilitate team meetings and educational sessions.
Cross-Functional CollaborationWork closely with:
- Senior Regional Managers
- Program Operations
- Client Program Directors
- Analytics
- Reporting Teams
- Training Department
- Compliance
- Quality Assurance
- Recruiting
- Human Resources
Compliance- Ensure all activities comply with:
- HIPAA
- OIG Guidelines
- FDA regulations
- Client SOPs
- Company Policies
- Privacy requirements
- Promote ethical business practices.
- Report compliance concerns appropriately.
Minimum QualificationsEducation- Bachelor's Degree or equivalent years of experience in the field reimbursement management and field leadership
- Experience in field based teams working in or with pharmaceutical companies
Experience- Minimum 5 years of healthcare reimbursement, market access, specialty pharmacy, or field reimbursement experience.
- Minimum 2 years of leadership or team lead experience preferred.
- Experience leading remote field teams strongly preferred.
- Experience supporting specialty, rare disease, oncology, immunology, neurology, or other complex therapeutic areas preferred.
- Experience working with manufacturers, specialty pharmacies, and provider offices.
Knowledge & SkillsReimbursement Expertise- Medical Benefit
- Pharmacy Benefit
- Prior Authorization
- Appeals
- Medicare
- Medicaid
- Commercial Insurance
- Specialty Pharmacy
- HUB Operations
- Buy-and-Bill
- Coding and Billing Fundamentals
Leadership Skills- Team coaching
- Performance management
- Conflict resolution
- Employee development
- Change management
- Executive communication
- Strategic thinking
- Decision-making
- Problem solving
Technical Skills- CRM platforms (Salesforce, Veeva, Lynk, QuickPath, or similar)
- Microsoft Office Suite
- PowerPoint
- Excel
- Reporting dashboards
- Virtual meeting platforms
- Data interpretation and trend analysis
- Core Competencies
- Leadership
- Accountability
- Customer Focus
- Strategic Thinking
- Collaboration
- Emotional Intelligence
- Business Acumen
- Adaptability
- Coaching & Mentoring
- Operational Excellence
- Communication
- Critical Thinking
- Relationship Building
- Time Management
Travel Requirements- Up to 40-60% travel based on program and client needs.
- Ability to travel by automobile and commercial airline.
- Overnight travel required.
Physical Requirements- Ability to travel extensively.
- Ability to sit and work at a computer for extended periods.
- Ability to present to small and large group
Physical Demands & Work Environment- While performing the duties of this job, the employee is regularly required to talk or hear. The employee is frequently required to sit for long periods of time, use hands to type, handle or feel; and reach with hands and arms. Prefer candidates who can type at least 35 words per minute with 97% accuracy.
- Although very minimal, flexibility to travel as needed is preferred.
- This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, etc.
Any offer of employment is contingent upon the successful completion of a background check and, depending on the position, a drug screen in accordance with company standards. Please note that this job description is not intended to be an exhaustive list of all duties, responsibilities, or activities associated with the position. Responsibilities and tasks may be modified at any time, with or without notice.
