Field Reimbursement Manager

Syneos Health, Inc.; Chicago (IL); On-site; USD 110,000 - 150,000; Full time

Benefits offered by this job

Health benefits

Company 401k match

Flexible PTO and sick time

Job summary

Syneos Health is seeking a Field Reimbursement Manager to serve as the reimbursement, access, and coverage subject-matter expert across the territory. You will analyze issues, educate HCPs and office staff, and partner with HUB services and specialty pharmacy to support patient access.

You will coordinate with field sales, ensure payer submissions, and guide teams through enrollment forms, prior authorization, and coding requirements across local payers and government programs.

Qualifications

• 5+ years’ experience pharmaceutical and/or biotech, and 2+ years in patient journey navigation, payer, reimbursement, medical billing & coding, specialty pharmacy & patient support services engagement.
• In-depth understanding of patient enrollment forms; prior authorization process; appeals; coding, coverage, and payment across all sites of care (e.g., offices, clinics, hospital).

Responsibilities

• Analyze access & reimbursement issues and opportunities.
• Educate office personnel on the patient journey for assigned product(s) and provide access & reimbursement expertise.
• Provide access & reimbursement education to field teams.
• Coordinate on access & reimbursement issues with third parties including HUB/Patient support services and liaise with specialty pharmacy for pharmacy benefit products.
• Educate HCPs on reimbursement processes, claims submissions, procedures and coding requirements of payer organizations (local payers, government payers, etc.).
• Provide information to HCP on how the products are covered under the benefit design and educate key private and public payer coverage and changes that impact the products access for patients.
• Must live within territory or within territory boundaries.

Skills

Reimbursement expertise

Payer navigation

Healthcare access

Job description

Updated: Today

Location: Chicago, IL, United States

Job ID: 16619-OTHLOC-CPKvYfwM

You are an expert facilitator: you open doors, foster communication, and bridge the gap.

In this role, the Field Reimbursement Manager (FRM) will operate as the subject‑matter expert on reimbursement, access, and coverage issues affecting the customers products. The FRM will analyze reimbursement and access issues and act as the local access and reimbursement resource for other field sales force personnel and region management.

Responsibilities

• Analyze access & reimbursement issues and opportunities.
• Educate office personnel on the patient journey for assigned product(s) and provide access & reimbursement expertise.
• Provide access & reimbursement education to field teams.
• Coordinate on access & reimbursement issues with third parties including HUB/Patient support services and liaise with specialty pharmacy for pharmacy benefit products.
• Educate HCPs on reimbursement processes, claims submissions, procedures and coding requirements of payer organizations (local payers, government payers, etc.).
• Provide information to HCP on how the products are covered under the benefit design and educate key private and public payer coverage and changes that impact the products access for patients.
• Must live within territory or within territory boundaries.

Qualifications

• 5+ years’ experience pharmaceutical and/or biotech experience and 2+ years’ relevant experience in patient journey navigation, payer, reimbursement, medical billings & coding, specialty pharmacy & distribution, and patient support services engagement.
• In-depth understanding of patient enrollment forms; prior authorization process; appeals; peer‑to‑peer interventions; coding, coverage, and payment across all sites of care (e.g., offices, clinics, hospital).

Desired Requirements

• Buy and bill product experience.
• Experience in rheumatology; dermatology; gastroenterology; and neurology.
• Immunology experience with self‑injection specialty pharmacy products.

Syneos Health companies are affirmative action/equal opportunity employers (Minorities/Females/Veterans/Disabled).

Benefits include a competitive compensation package, Health benefits (Medical, Dental, Vision), Company match 401k, flexible paid time off (PTO) and sick time. Eligibility for paid sick time may vary depending on location. Syneos Health complies with all applicable federal, state, and municipal paid sick time requirements.