Field Reimbursement Manager (FRM) — Territory covers: Flint/Lansing/Grand Rapids/Saginaw/Traverse City, MI and Fort Wayne/South Bend, IN. Supporting the Respiratory business unit.
Responsibilities:
- Manage defined accounts for Patient Access & Reimbursement within a specified geography.
- Act as an extension of the HUB with live one-on-one coverage.
- Support the reimbursement journey from physician order through payer prior authorization, appeals/denials requirements, and forms.
- Review patient-specific information for site-requested assistance resolving coverage challenges.
- Educate HCPs on key private/public payer coverage changes affecting patient access.
- Coordinate access/reimbursement issues with relevant partners (including the HUB).
- Provide coverage/benefit design information (Commercial, Medicare, Medicaid).
- Serve as payer expert and promptly communicate payer changes.
- Provide office education using approved materials (formulary/utilization management, forms/procedures, benefits investigation, prior auth, appeal/claims resolution).
- Review insurance benefit options and alternate funding/financial assistance programs.
- Collaborate with other departments to resolve reimbursement issues.
Working conditions:
- 3 days/week in geography; remote/WFH; 1–2 home office days/week; travel 60–80%; valid driver’s license.
Basic Qualifications:
- Doctorate OR Master’s + 3 yrs customer service/leadership OR Bachelor’s + 5 yrs OR Associate’s + 10 yrs OR HS/GED + 12 yrs customer service/leadership; plus experience managing people/leading teams/projects/programs/resources.
Minimum Qualifications:
- 2+ yrs in third-party access/pharma in managed care/clinical support/sales; strong medical reimbursement; presentation/facilitation; written/oral communication; project management; Word/Excel/PowerPoint/web meetings; healthcare industry (insurance verification/claim adjudication/clinics/pharmacies/manufacturers); hub and billing/coding/appeals knowledge; cross-functional collaboration; experience with commercial/Medicare/state Medicaid; live in geography or within 10 miles.
Preferred Qualifications:
- Bachelor’s in business/healthcare/related; 6 yrs with specialty/biologic self-injectable (pharmacy benefit) or physician-administered (buy & bill/medical); advanced insurance terminology; CMS/Medicare (Part B/Part D) knowledge; ambiguity/problem-solving; manage expenses.
Application instructions:
- Apply at careers.amgen.com. No application deadline; applications accepted until sufficient number received or candidate selected.