Sr. Director, Field Reimbursement
Harrow
August 14, 2026
Remote
United States
Market Access
Position Summary
- Build and lead a national team of Field Reimbursement Managers (FRMs) to support a buy-and-bill drug portfolio across Retina and Surgical franchises. Architect field reimbursement strategy and culture to help physician practices navigate coverage, coding, billing, and claims.
Core Responsibilities
Team Leadership & Culture
- Build, lead, coach, and scale FRM team; define structure, territory alignment, KPIs, and performance standards; conduct field visits/ride-alongs and reviews.
- Recruit and develop reimbursement talent; create career pathing and FRM training curricula.
- Foster cross-functional collaboration with Sales, Trade, Marketing, Market Access/Payer Strategy, Legal, and Compliance.
Strategy & Customer Confidence
- Set national strategy for field reimbursement support.
- Provide proactive education to physicians and practice staff on coverage policy, coding, billing, and claims submission.
- Lead business reviews with key accounts to assess reimbursement performance, identify access barriers, and develop corrective action plans.
- Serve as senior escalation point for complex payer/coding/claims issues.
Payer, Billing & Coding Expertise
- Maintain current expertise in payer dynamics (commercial, Medicare, Medicare Advantage, Medicaid).
- Provide guidance on HCPCS/CPT/J-code assignment, ICD-10 coding, modifiers, prior authorization, and appeals for Retina/Surgical procedures.
- Ensure guidance is accurate, compliant, and education-focused (not customer billing/coding advice).
Claims & Business Analytics
- Direct claims analysis to identify trends, denial patterns, coverage gaps, and access barriers.
- Translate insights into field action plans and customer recommendations.
- Partner with Market Access and Trade teams to inform payer strategy and contracting priorities.
- Own reporting/dashboards for access metrics and franchise reimbursement KPIs.
Compliance
- Ensure adherence to compliance policies, OIG guidance, and applicable state/federal regulations; partner with Legal/Compliance on training and monitoring.
Qualifications & Requirements
- Bachelor’s degree required; MBA/MHA or related degree a plus.
- 10+ years in market access, reimbursement, or trade (buy-and-bill/specialty pharma/biotech preferred).
- 5+ years people leadership experience building field reimbursement/access teams.
- Demonstrated expertise in payer policy, medical/pharmacy benefit dynamics, CPT/HCPCS/ICD-10, billing workflows, and claims/appeals.
- Retina/Ophthalmology/Surgical specialty market experience strongly preferred.
- Proven claims data analysis skills; track record improving patient access and reimbursement outcomes.
- Strong executive presence and stakeholder influence.
- Working knowledge of reimbursement support compliance requirements (PhRMA Code, OIG guidance, anti-kickback considerations).
Position Type/Travel
- Remote
- Up to 75% travel
- Build and lead a national team of Field Reimbursement Managers (FRMs) to support a buy-and-bill drug portfolio across Retina and Surgical franchises. Architect field reimbursement strategy and culture to help physician practices navigate coverage, coding, billing, and claims.
Core Responsibilities
Team Leadership & Culture
- Build, lead, coach, and scale FRM team; define structure, territory alignment, KPIs, and performance standards; conduct field visits/ride-alongs and reviews.
- Recruit and develop reimbursement talent; create career pathing and FRM training curricula.
- Foster cross-functional collaboration with Sales, Trade, Marketing, Market Access/Payer Strategy, Legal, and Compliance.
Strategy & Customer Confidence
- Set national strategy for field reimbursement support.
- Provide proactive education to physicians and practice staff on coverage policy, coding, billing, and claims submission.
- Lead business reviews with key accounts to assess reimbursement performance, identify access barriers, and develop corrective action plans.
- Serve as senior escalation point for complex payer/coding/claims issues.
Payer, Billing & Coding Expertise
- Maintain current expertise in payer dynamics (commercial, Medicare, Medicare Advantage, Medicaid).
- Provide guidance on HCPCS/CPT/J-code assignment, ICD-10 coding, modifiers, prior authorization, and appeals for Retina/Surgical procedures.
- Ensure guidance is accurate, compliant, and education-focused (not customer billing/coding advice).
Claims & Business Analytics
- Direct claims analysis to identify trends, denial patterns, coverage gaps, and access barriers.
- Translate insights into field action plans and customer recommendations.
- Partner with Market Access and Trade teams to inform payer strategy and contracting priorities.
- Own reporting/dashboards for access metrics and franchise reimbursement KPIs.
Compliance
- Ensure adherence to compliance policies, OIG guidance, and applicable state/federal regulations; partner with Legal/Compliance on training and monitoring.
Qualifications & Requirements
- Bachelor’s degree required; MBA/MHA or related degree a plus.
- 10+ years in market access, reimbursement, or trade (buy-and-bill/specialty pharma/biotech preferred).
- 5+ years people leadership experience building field reimbursement/access teams.
- Demonstrated expertise in payer policy, medical/pharmacy benefit dynamics, CPT/HCPCS/ICD-10, billing workflows, and claims/appeals.
- Retina/Ophthalmology/Surgical specialty market experience strongly preferred.
- Proven claims data analysis skills; track record improving patient access and reimbursement outcomes.
- Strong executive presence and stakeholder influence.
- Working knowledge of reimbursement support compliance requirements (PhRMA Code, OIG guidance, anti-kickback considerations).
Position Type/Travel
- Remote
- Up to 75% travel