Access & Reimbursement Manager (ARM) - PNW

Outlook Therapeutics, Inc.; San Francisco (CA); On-site; USD 100,000 - 170,000; Full time

Benefits offered by this job

Competitive base salary

Annual performance bonus

Equity

Health coverage

Job summary

Outlook Therapeutics, Inc. is seeking a Field Reimbursement Manager to drive access strategy for our retina portfolio in the U.S. Field-based role with 50–70% travel within the Pacific Northwest.

You will own reimbursement education, payer negotiations, and cross‑functional alignment to support a successful US launch. You will partner with practice staff, payers, and internal teams to improve access and outcomes, guided by regulatory and policy requirements.

Qualifications

• 5–10 years of combined experience in reimbursement, market access, patient services, or related field within pharmaceuticals, biotech, or specialty healthcare.
• At least 2 years of dedicated field reimbursement experience.
• Hands‑on experience with Medicare/MACs, Medicare Advantage, Medicaid, and commercial payer coverage.
• Proficiency with claims data, prior authorization, and appeals processes.

Responsibilities

• Serve as the primary field reimbursement resource for retina/ophthalmology accounts and practice staff.
• Educate on payer coverage policies, billing, coding, and prior-authorization requirements.
• Lead quarterly business reviews and analyze reimbursement trends to improve denial rates.
• Coordinate with Sales and cross-functional teams to ensure consistent messaging and smoother access.

Skills

Reimbursement expert

Market access

CRM proficiency

Excel

Communication

Travel readiness

Tools

CRM systems

Job description

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.

THE OPPORTUNITY

Reports To

Sr. Director, Patient Access & National Field Reimbursement

Territory:

Pacific Northwest

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 $100,000-$170,000, 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.