Position Summary:
The Field Reimbursement Manager (FRM) is a field-based expert in market access and reimbursement, providing education and support across the reimbursement and access journey (claims submissions, prior authorization, coverage criteria, and payer-specific requirements) for commercial, Medicare, and Medicaid.
Responsibilities:
- Resolve complex patient access barriers (prior authorizations, appeals, denials) with customers/accounts.
- Educate provider practices and staff on reimbursement support programs, coverage, coding, and payer policies.
- Minimize access barriers to enable appropriate patients to obtain Invivyd products through HCP education.
- Deliver clear, actionable guidance to practice managers, billing staff, nurses, and reimbursement teams.
- Review practice utilization of reimbursement support services and recommend enhancements.
- Report payor trends for approved products to Patient Services and Market Access account management.
- Maintain deep expertise in coverage pathways (medical and pharmacy benefit) and the Medicare reimbursement landscape.
- Educate providers on navigating reimbursement processes and payer trends across national/regional payors.
- Train healthcare professionals on drug reimbursement, coding, and billing practices.
- Navigate access/reimbursement concerns by coordinating with appropriate stakeholders; track business trends, regulatory changes, and healthcare policy impacts.
- Present insights and trends to commercial and executive leadership; ensure compliance with pharmaceutical regulations and ethical guidelines.
Requirements:
- Bachelorβs degree strongly preferred; equivalent relevant experience considered.
- 8+ years in pharmaceutical/biotechnology with Market Access, Payer Account Management, and/or Access & Reimbursement experience.
- Ability to develop strategic account plans and oversee contract performance.
- Proven success meeting/exceeding business KPIs.
- Working knowledge of formulary inclusion process and familiarity with sub-committees.
- Analytical mindset; interpret sales data, market trends, customer insights.
- Experience with CRM systems and sales analytics tools.
- Ability to travel ~60%.
Pay Range:
$152,000 - $202,000 base salary; eligible for annual short-term incentive and annual long-term incentive (bonus/equity).