Field Reimbursement Manager, Eye Care

Role Summary

This field-based role serves as an in-office resource addressing health care professional questions about patient access and reimbursement for Eye Care products. The FRM travels to HCP offices within a defined geography to educate on coverage, reimbursement challenges, and payer processes. The role requires staying current on managed care policies and maintaining relationships with providers in the territory.

Responsibilities

• Educate HCPs on patient support programs, including access and reimbursement tools and services
• Educate on product-specific acquisition and access options such as specialty pharmacy networks, specialty distribution, and white-bagging support
• Educate on resources available to address access issues
• Provide local expertise on national/regional payor policies to educate providers on payer issues, coding changes, and appropriate claims submission processes
• Liaise with Access and Reimbursement support center to update HCPs on Rx status and program eligibility
• Report payer trends related to approved products to Patient Services and Market Access account management teams
• Establish and maintain relationships with appropriate providers within territory
• Remain current on key managed care, reimbursement, and policy activities

Qualifications

• At least 3 years of experience in Buy and Bill Access and Reimbursement, Payer Account Management, and/or Market Access
• Thorough understanding of payer policy processes, systems, and requirements for coverage, coding, and payment for specialty medicines
• Demonstrated understanding of rules, regulations, and risks associated with reimbursement support services
• Strong ability to communicate technical elements of coding and billing requirements at the national and regional level across care settings
• Comprehensive understanding of Parts A, B, C and D or Medicare and related reimbursement dynamics
• Strong understanding of drug acquisition and dispensing in Eye Care (Buy and Bill, Specialty Pharmacies, Specialty Distributors, etc.)
• Strong understanding of reimbursement support service centers and compliant engagement
• Excellent territory and account management skills
• Bachelor’s degree
• Ability to drive a personal auto or company vehicle
• Valid driver’s license and ability to pass pre-employment drug screening
• Mandatory health care industry representative (HCIR) credentialing or eligibility and ongoing maintenance for entry into facilities in the assigned territory

Education

• Bachelor’s degree

Additional Requirements

• Must drive a personal or company vehicle; valid driver's license required
• Ability to pass pre-employment drug screening and meet safe driving requirements
• HCIR credentialing requirements to enter facilities; responsibility to satisfy all related requirements and liabilities