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 Collaboration
Work 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 Qualifications
Education
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 & Skills
Reimbursement 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.
