Field Reimbursement Manager, Eye Care

Role Summary

Field-based Field Reimbursement Manager, Eye Care (FRM) operating within a defined geography in the Eye Care portfolio. This role serves as an alternative in-office resource to address health care provider questions about patient access and reimbursement, traveling to HCP offices in the assigned geography to educate on coverage, payer processes, and program eligibility. The FRM provides expertise on coverage and common access and reimbursement challenges affecting buy-and-bill products, and educates on AbbVie access and reimbursement tools.

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 AbbVie’s 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 the technical payer policy processes, systems and requirements for coverage, coding and payment for specialty medicines
• Demonstrated understanding of the rules, regulations and risks associated with provision of reimbursement support services
• Strong understanding and ability to communicate technical elements of coding and billing requirements at the National and Regional level across all settings of care
• Comprehensive understanding of Parts A, B, C and D or Medicare and associated reimbursement dynamics
• Strong understanding of drug acquisition and dispensing in the Eye Care space (Buy and Bill, Specialty Pharmacies, Specialty Distributors, etc.)
• Strong understanding of access and reimbursement support service centers and how to effectively interact in a compliant fashion
• Excellent territory and account management skills
• Bachelor’s degree
• Driving a personal auto or company car or truck, or a powered piece of material handling equipment
• Valid driver’s license: Ability to pass a pre-employment drug screening test and meet safe driving requirements
• Health care industry representative (HCIR) credentialing requirements to gain and maintain entry into facilities and organizations within the assigned territory; must be in good standing or eligible to obtain these credentials
• HCIR credentialing requirements may include background checks, drug screens, immunization/vaccination proof, fingerprinting, and state/city licenses; candidate is responsible for satisfying all HCIR requirements

Education

• Bachelor’s degree

Additional Requirements

• Pass all applicable HCIR credentialing requirements to gain/maintain entry into facilities and organizations in the assigned territory
• Ability to travel to assigned geographic locations as required