Access & Reimbursement Manager (ARM) - Mid-Atlantic

Outlook Therapeutics, Inc.; Ohio; Remote; USD 125,000 - 190,000; Full time

Job summary

Outlook Therapeutics, Inc. is seeking an experienced Field Reimbursement Manager to drive access and payer strategy for our US retina launch. You will own a defined territory (PA, MD, DC, VA) and serve as the primary reimbursement resource for practices.

You will lead quarterly business reviews, analyze denial trends, and coordinate with Sales to ensure cohesive messaging. Travel 50–75% is required. 5–10 years of related experience is expected.

Qualifications

• 5–10 years combined experience in reimbursement/market access in pharma or biotech.
• At least 2 years of dedicated field reimbursement experience.
• Hands-on Medicare/Medicare Advantage, Medicaid and commercial payer coverage.
• Experience with benefit verification, prior authorization, claims support and appeals.
• Strong verbal and written communication; builds trust with office staff.
• Proficient with CRM systems and Excel.
• Ability to travel 50–75%; valid driver’s license.
• Demonstrated compliance mindset in a non-promotional field role.

Responsibilities

• Serve as the primary field reimbursement resource for retina practices and staff.
• Educate staff on payer coverage policy, coding, prior-authorization requirements.
• Guide practices through prior authorizations and appeals processes.
• Coordinate with Sales to ensure consistent, compliant messaging.
• Partner with patient support and cross-functional teams; maintain CRM records.

Skills

Reimbursement expertise

Market access

Patient services

Claims data analysis

Communication skills

CRM proficiency

Travel willingness

Regulatory/compliance mindset

Tools

CRM systems

Microsoft Excel

Job description

THE OPPORTUNITY

Outlook Therapeutics (Nasdaq: OTLK) is a commercial-stage biopharmaceutical company redefining the standard of care in retinal disease. In the United States, our lead product has received FDA approval, making it the first and only FDA-approved ophthalmic formulation of its kind for the treatment of wet AMD, and we are preparing for US commercial launch. Our lead product is also the first ophthalmic formulation of its kind to receive Marketing Authorization from the European Commission and the UK MHRA for the treatment of wet age‑related macular degeneration (wet AMD), and has launched across Germany, Austria, and the UK. Driven by the stories of the patients we serve, we are united with the vision‑care community around a single goal: a future where everyone with retinal disease can envision a brighter world.

Reports To Sr. Director, Patient Access & National Field Reimbursement

Territory PA, MD, DC, VA

Location Field-Based (U.S.) — territory travel required 50-70%

Employment Type Full-time

Direct Reports No

This is a rare ground‑floor moment at a company hitting its commercial inflection point. As a lean, fast-moving organization, we offer scope and ownership that larger companies can’t: your work is visible, your decisions matter, and you’ll help build the function rather than simply maintain it. You’ll partner directly with senior leadership and see a clear line between what you do and patients gaining access to a new treatment option.

You’ll be the reimbursement and access expert retina and ophthalmology practices call first — building the trusted relationships and payer playbooks that set the field team up for a successful U.S. launch.

WHAT YOU'LL DO

Customer Education & Reimbursement Support

• Serve as the primary field reimbursement resource for practice administrators, billing/coding staff, and clinical teams supporting our retina portfolio.


• Educate office staff on payer coverage policy, medical-benefit billing and coding (HCPCS/CPT/J-codes, ICD-10, modifiers), prior-authorization requirements, and clean-claim submission.


• Guide practices through the prior-authorization and appeals process, clarifying payer-specific requirements and documentation.


• Connect practices to patient-support resources when a case needs that level of help.

Account Management & Business Reviews

• Own a defined territory of retina/ophthalmology accounts and build the kind of trust that makes you the first call for a reimbursement problem.


• Lead quarterly business reviews, analyzing reimbursement performance and denial trends and leaving each account with a concrete plan to fix what isn’t working.


• Monitor accounts for early warning signs — rising denials, patients not being filled due to access friction — and get ahead of the problem with a targeted plan.


• Coordinate with Sales so every account gets one consistent, compliant message.

Claims & Payer Analysis

• Analyze account-level claims data to spot denial patterns, coding errors, and payer-specific quirks, and turn findings into plain-language guidance practices can act on.


• Track how commercial, Medicare, Medicare Advantage, and Medicaid plans are covering the territory’s products as policy shifts.


• Escalate systemic payer issues — a policy change, a recurring denial pattern — to Access & Reimbursement leadership with supporting data and a recommended next step.


• Support U.S. launch readiness by mapping the payer landscape and feeding access-strategy input to Market Access ahead of approval.

Cross-Functional Collaboration & Reporting

• Partner with the patient support hub and Patient Services so benefit verification, prior-authorization/appeals help, and patient-assistance referrals move smoothly between teams.


• Bring a field-level view into cross-functional territory and launch planning.


• Keep account activity, QBR outcomes, and issue resolution logged accurately and on time in the CRM.

WHAT YOU'LL BRING

Required

• 5–10 years of combined experience in reimbursement, market access, patient services, or a related field within pharmaceuticals, biotech, or specialty healthcare, including at least 2 years of dedicated field reimbursement experience.


• Hands‑on experience navigating Medicare (including MACs), Medicare Advantage, Medicaid, and commercial payer coverage.


• Practical experience with benefit verification, prior authorization, claims support, and the appeals process.


• Track record of using claims data to identify denial trends and coding-related barriers.


• Strong verbal and written communication skills, with the ability to build trust with office staff without engaging in promotional discussion.


• Proficiency with CRM systems and Microsoft Excel.


• Ability to travel within an assigned territory (typically 50–75%, including some overnight travel); valid driver’s license required.


• Demonstrated compliance mindset and ability to operate within a highly regulated, non-promotional field role.

Preferred

• Experience in ophthalmology, retina, or another buy-and-bill/injectable specialty therapeutic area.


• Experience with HCPCS Level II (J‑code) and CMS Transitional reimbursement pathways.


• Prior experience supporting product launch or pre-launch access planning.


• Relevant certification such as Certified Professional Coder (CPC) or Professional, Academy for Healthcare Management (PAHM).

WHAT WE OFFER

• Competitive base salary, annual performance bonus, and equity — so you share in the value you help create


• Comprehensive health coverage: medical, dental, and vision


• 401(k) with company match


• Generous paid time off and company holidays


• A high-trust, low-bureaucracy culture with direct access to leadership and real room to grow


• Mission-driven work that helps preserve sight for patients who are counting on it

COMPENSATION

In keeping with our commitment to pay transparency, the good‑faith base salary range for this role is $125,000-$190,000, with an annual target bonus of 10-20%. This role is also eligible for a meaningful equity grant, reflecting the opportunity to build lasting value at a company at a commercial inflection point. Final compensation reflects experience, skills, and location.

OUR COMMITMENT

Outlook Therapeutics is an equal opportunity employer. We are committed to building an inclusive environment where every team member can do their best work, and we consider all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other characteristic protected by law.