Field Reimbursement Manager, West
Invivyd
4 days ago
On-site
San Francisco, CA
$152,000 - $202,000 USD yearly
Market Access
Position Summary
- Field Reimbursement Manager (FRM) is a field-based expert in market access and reimbursement, educating healthcare providers and stakeholders on claims, prior authorizations, coverage criteria, and payer requirements across commercial, Medicare, and Medicaid.
Responsibilities
- Resolve complex reimbursement issues (prior authorizations, appeals, denials) to remove patient access barriers.
- Educate private practices, multi-specialty groups, facilities, and staff on reimbursement support programs, coverage, coding, and payer policies.
- Minimize access barriers and support timely patient access to therapy via HCP education.
- Provide clear guidance to practice managers, billing staff, nurses, and reimbursement teams.
- Review practice use of reimbursement support services and recommend program enhancements.
- Report payer trends for approved products to Patient Services and Market Access teams.
- Serve as expert on coverage pathways (medical and pharmacy benefit) and the Medicare reimbursement landscape.
- Educate providers on navigating reimbursement processes and payer trends; deliver training on drug reimbursement, coding, and billing.
- Manage access/reimbursement concerns by coordinating appropriate internal stakeholders; stay current on regulatory and policy changes.
- Present insights to commercial and executive leadership; ensure compliance with pharmaceutical regulations, industry standards, and ethical guidelines.
Requirements
- Bachelor’s degree strongly preferred (or significant relevant industry experience).
- 8+ years in pharma/biotech with Market Access, Payer Account Management, and/or Access & Reimbursement.
- Ability to develop strategic account plans and oversee contract performance.
- Proven success meeting/exceeding business KPIs.
- Working knowledge of formulary inclusion and sub-committees.
- Analytical mindset; interpret sales data, market trends, and customer insights.
- Experience with CRM systems and sales analytics tools.
- Travel as required (~60%).
- Field Reimbursement Manager (FRM) is a field-based expert in market access and reimbursement, educating healthcare providers and stakeholders on claims, prior authorizations, coverage criteria, and payer requirements across commercial, Medicare, and Medicaid.
Responsibilities
- Resolve complex reimbursement issues (prior authorizations, appeals, denials) to remove patient access barriers.
- Educate private practices, multi-specialty groups, facilities, and staff on reimbursement support programs, coverage, coding, and payer policies.
- Minimize access barriers and support timely patient access to therapy via HCP education.
- Provide clear guidance to practice managers, billing staff, nurses, and reimbursement teams.
- Review practice use of reimbursement support services and recommend program enhancements.
- Report payer trends for approved products to Patient Services and Market Access teams.
- Serve as expert on coverage pathways (medical and pharmacy benefit) and the Medicare reimbursement landscape.
- Educate providers on navigating reimbursement processes and payer trends; deliver training on drug reimbursement, coding, and billing.
- Manage access/reimbursement concerns by coordinating appropriate internal stakeholders; stay current on regulatory and policy changes.
- Present insights to commercial and executive leadership; ensure compliance with pharmaceutical regulations, industry standards, and ethical guidelines.
Requirements
- Bachelor’s degree strongly preferred (or significant relevant industry experience).
- 8+ years in pharma/biotech with Market Access, Payer Account Management, and/or Access & Reimbursement.
- Ability to develop strategic account plans and oversee contract performance.
- Proven success meeting/exceeding business KPIs.
- Working knowledge of formulary inclusion and sub-committees.
- Analytical mindset; interpret sales data, market trends, and customer insights.
- Experience with CRM systems and sales analytics tools.
- Travel as required (~60%).