Field Reimbursement Manager

RXinsider LTD.; Madison (WI); On-site; USD 80,000 - 134,000; Full time

Benefits offered by this job

Annual bonus

Long-term incentive opportunities

Total Rewards program

Job summary

McKesson is looking for a Field Reimbursement Manager to support reimbursement and patient services for a designated territory, focusing on education and provider engagement.

You will collaborate with physicians, office staff, and manufacturers to deliver reimbursement services, including benefit investigations and prior authorizations. Expect 80% travel within Madison, Milwaukee, and Minneapolis areas and strong CRM use.

Qualifications

• Requires 4-year degree or equivalent experience.
• 4+ years healthcare reimbursement experience.
• Must have Medicare and commercial insurance coverage experience.

Responsibilities

• Provide on-site and remote education on reimbursement challenges and services.
• Educate on Benefit Investigation, Prior Authorization, and Medicare/Commercial coverage.
• Perform case management support with providers and manufacturers; document outcomes.
• Schedule and conduct outbound calls to offices; manage backlog casework.
• Monitor performance and report trends via FRM CRM dashboards.
• Develop provider and manufacturer data in the reimbursement database.

Skills

Medicare knowledge

Commercial insurance

Education/presentation

Account coordination

Multi-tasking

CRM experience

Education

4-year degree or equivalent experience

Tools

PowerPoint

Web meetings

FRM CRM system

Job description

McKesson is an impact-driven, Fortune 10 company that touches virtually every aspect of healthcare. We are known for delivering insights, products, and services that make quality care more accessible and affordable. Here, we focus on the health, happiness, and well-being of you and those we serve – we care.

What you do at McKesson matters. We foster a culture where you can grow, make an impact, and are empowered to bring new ideas. Together, we thrive as we shape the future of health for patients, our communities, and our people. If you want to be part of tomorrow’s health today, we want to hear from you.

The CoverMyMeds Field Reimbursement Manager (FRM) is responsible for managing an assigned territory focused on supporting Reimbursement and Patient services by providing assistance with patient reimbursement challenges for a specific drug (including Benefit Investigation, Prior Authorization, Claims Assistance, and Appeals) and educating the office on Payer landscape and services available through both remote interaction and on-site training. This position is client-facing and customer-facing and requires the ability to build relationships with physician offices as well as manufacturer representatives to effectively deliver services based on customer specific preferences. The Field Reimbursement Manager works independently in a fast paced, highly visible environment as well as collaboratively with the internal program hub support services to ensure all customer needs are met. FRM will frequently interact via telephone with providers and internal staff to arrange site visits, Manufacturer trainings, and educational training venues. Must have a solid working knowledge of Medicare and Commercial insurance plans and benefit structures in order to relay detailed benefit information and maximize the customer experience. Position will require travel, project management and/or account coordination based on client expectation.

Required: Candidate must live within the Madison, WI, Minneapolis, MN or Milwaukee, WI area.

Key Responsibilities:

• Provide on-site and on-demand education (including Lunch and Learns or Dinner presentations) for the office staff in regard to Reimbursement challenges and support services that are available. Office interaction will include education and reimbursement support. On-site/virtual interactions will average 15 per week. These activities are recorded in FRM CRM daily with reporting to manager weekly.
• Educate on Benefit Investigation, Prior Authorization Process, Support Center Services, Medicare and Commercial coverage and patient communication streams. Monthly activity reporting captures educational topics at FRM level reportable to client based on client expectation. This trended data is also reported quarterly to client.
• Reimbursement Support on Case management, billing and coding updates, appropriate claims submission, Specialty Pharmacy, Medical Benefit Interpretation, understanding medical necessity, claims and appeal assistance, information related to co-pay assistance and patient assistance programs. FRM will collaborate with case manager on average of 4/month and ad hoc as needed for escalations. These interactions are tracked in FRM CRM and hub system.
• Responsible for setting up appointments and completing outbound calls to targeted offices. Assist in completing backlog casework. Additional day-to-day in-office work. Interface with physicians and manufacturer representatives to obtain and provide patient and provider specific information. All FRM interactions/activities are tracked in FRM CRM which are reportable to management and client.
• Monitor program performance for physicians and manufacturer representatives in accordance with expectations. Territory performance will be monitored via FRM CRM dashboard daily. Trending results will be identified through quarterly reporting. Additionally, clients have the option to survey customers on program performance.
• Research and compile provider / manufacturer representative specific information for reimbursement database. (Includes account profiles) FRM will create a facility database on each new provider in FRM CRM. All interactions/activities are built utilizing this database.

Minimum Job Qualifications –

• 4-year degree in related field or equivalent experience
• 4+ years of healthcare related reimbursement experience

Business Experience –

• Strong medical reimbursement experience with Buy & Bill and/or Specialty Pharmacy.
• Experience in the healthcare industry including, but not limited to insurance verification, prior authorizations, and/or claim adjudication, physician’s office or clinics.
• Must have Medicare and commercial insurance coverage experience.
• Must be able to deliver and document benefit investigation outcomes and relay status reports on a regular basis.
• Proven presentation skills and experience
• Proven ability to effectively handle multiple priorities and excellent organizational skills
• Strong Computer literacy to include PowerPoint and Web Meeting experience

Specialized Knowledge/Skills –

• Previous field experience, a plus
• Previous experience with specialty pharmacy a plus
• Account management experience, a plus
• Excellent Interpersonal skills.
• Excellent written and oral communication skills
• Problem solving and decision-making skills

Working Conditions:

General Office Demands – Remote, WFH

Travel Requirements

Must reside in territory - Madison, WI, Minneapolis, MN or Milwaukee, WI area.

Must be able to travel 80% (4 days a week) via automobile or plane

Must have a valid driver's license with a clean driving record/ MVR

Physical Requirements (Lifting, Standing, Etc.)

Possible long periods of sitting and/or keyboard work. General office demands.

We are proud to offer a competitive compensation package at McKesson as part of our Total Rewards. This is determined by several factors, including performance, experience and skills, equity, regular job market evaluations, and geographical markets. The pay range shown below is aligned with McKesson's pay philosophy, and pay will always be compliant with any applicable regulations. In addition to base pay, other compensation, such as an annual bonus or long-term incentive opportunities may be offered. For more information regarding benefits at McKesson, please click here.

Our Base Pay Range for this position

$80,300 - $133,800

McKesson is an Equal Opportunity Employer

McKesson provides equal employment opportunities to applicants and employees, without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, age, genetic information, or any other legally protected category. For additional information on McKesson’s full Equal Employment Opportunity policies, visit our Equal Employment Opportunity page.

McKesson is committed to being an Equal Employment Opportunity Employer and offers opportunities to all job seekers including job seekers with disabilities. If you need a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to (United States) [e-mail] or (Canada) [e-mail]. Resumes or CVs submitted to this email box will not be accepted.

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