Field Reimbursement Manager (FRM)
Key Responsibilities
- Act as a compliant subject matter expert (SME) in reimbursement, access, and specialty distribution for assigned geography.
- Educate HCP offices on coverage status, prior authorization processes, appeals, and alternate funding options for uninsured/underinsured patients.
- Build and maintain relationships with HCPs, office staff, and health system stakeholders.
- Analyze regional/local payer coverage trends, reimbursement criteria, and payer mix.
- Provide guidance on specialty pharmacy services and help navigate complex distribution channels.
- Partner with Patient Support to ensure accurate benefit investigations and streamlined patient onboarding.
- Collaborate with internal partners to build local access strategies aligned with business objectives.
- Develop and execute territory-level business plans using strategic customer insights.
- Resolve reimbursement issues and escalate cases as needed.
- Identify process improvements to enhance patient access and provider satisfaction.
- Maintain compliance with applicable legal/regulatory requirements and patient privacy/promotional conduct policies.
Requirements
- Bachelorβs degree in an allied health field preferred or equivalent work experience.
- 8+ years in pharmaceutical/biotech/related healthcare industry.
- Prior reimbursement experience required: substantial experience with prior authorizations and navigating the US payer landscape.
- 3β6 years supporting Specialty Pharmaceuticals/Biologics.
- Deep understanding of reimbursement, access, and specialty pharmacy operations.
- Experience supporting product launches or guiding patients through insurance approval processes.
- Strong understanding of Specialty Pharmacy distribution models and patient services programs.
- Knowledge of HIPAA and other federal/state laws for patient confidentiality/healthcare communications.
- Bilingual (English/Spanish) highly desired.
- Proven track record supporting complex therapies in rare/specialty conditions.
- Exceptional communication/interpersonal skills; builds trust with providers and internal partners.
- Comfortable with ambiguity, managing multiple cases, and solving problems in real time.
- Digital fluency with CRM platforms; comfortable educating patients on technology-enabled support tools, including AI-based platforms.
Benefits
- 401(k) plan with company match; comprehensive medical/dental/vision.
- Company-paid Life and AD&D; company-paid short- and long-term disability.
- Voluntary Pet Insurance and Legal Insurance.
- Employee Assistance Program (EAP).
- Employee Discounts and Professional Development programs.
- HSA and FSA.
- Accident, Critical Illness, and Hospital Indemnity Insurance.
- Paid parental leave and mental health resources.
- Performance-based incentive compensation plans.
- Annual base salary: $180,000β$190,000 (varies by qualifications/skills/competencies).