Field Reimbursement Manager

GForce Life Sciences; United States; Remote; USD 78,000 - 84,000; Full time

Job summary

GForce Life Sciences is seeking a Field Reimbursement Manager for a 6-month contract with potential for extension. This remote role requires 75% travel and focuses on reimbursement inquiries, collaborating with healthcare providers, and ensuring compliance with regulations. Candidates should have a bachelor's degree and significant experience in pharmaceutical sales or reimbursement, particularly in hemophilia treatments.

Benefits

Medical insurance

Vision insurance

Qualifications

• 4+ years in pharmaceutical sales or reimbursement.
• 2+ years in field reimbursement (pharmacy and buy-and-bill).
• In-depth knowledge of Medicare, Medicaid, and Commercial payer billing practices.

Responsibilities

• Act as primary contact for reimbursement inquiries related to hemophilia therapies.
• Collaborate with provider offices and specialty pharmacies to support access.
• Monitor reimbursement trends and policy changes.

Skills

Compliance

Reimbursement Inquiries

Analytical Skills

Education

Bachelor’s degree in science or business

Tools

CRM/reimbursement software

Job description

Direct message the job poster from GForce Life Sciences

Executive MSP Recruiter at GForce Life Sciences

Field Reimbursement Manager

6-month contract - potential to extend

Remote in Plainsboro, NJ

75% Travel Required

Key Responsibilities:

• Act as primary contact for reimbursement inquiries related to hemophilia therapies.
• Collaborate with provider offices and specialty pharmacies to support access and reimbursement.
• Monitor reimbursement trends and policy changes affecting hemophilia treatment.
• Track and report key performance indicators related to access and reimbursement.
• Support benefit investigations, prior authorizations, and appeals in coordination with team.
• Ensure compliance with applicable reimbursement regulations.
• Build understanding of billing/coding practices, payer landscape, and patient demographics.
• Utilize approved tools (dashboards, coding guides) to streamline access to therapy.
• Analyze and address reimbursement challenges through cross-functional collaboration.
• Manage assigned budget and execute additional projects as needed.

Access Education:

• Educate HCPs and support staff on reimbursement processes and financial assistance options.
• Support understanding of insurance benefits and access pathways.
• Train internal teams on reimbursement tools and procedures.
• Provide approved educational materials on reimbursement and coverage criteria.

Qualifications:

• Bachelor’s degree in science or business required.
• 4+ years in pharmaceutical sales or reimbursement; 2+ years in field reimbursement (pharmacy and buy-and-bill).
• In-depth knowledge of Medicare, Medicaid, Commercial payer billing practices.
• Familiarity with HUB services, patient support programs, and distribution models.
• Preferred: Experience in hemophilia or rare disease reimbursement.

Technical Expertise Required:

• Proficient in prior auths, J-codes, billing/coding, appeals, and HUB operations.
• Understanding of payer policies, utilization management, and HIPAA.
• Ability to use CRM/reimbursement software and reporting tools.

Seniority level

• Seniority level

  Not Applicable

Employment type

• Employment type

  Contract

Job function

• Job function

  Other

• Industries

  Medical Equipment Manufacturing, Pharmaceutical Manufacturing, and Biotechnology Research

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Inferred from the description for this job

Medical insurance

Vision insurance

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