Field Reimbursement Manager - Louisiana

BioSpace; New Orleans (LA); Remote; USD 155,000 - 174,000; Full time

Job summary

A leading biotechnology company is seeking a Field Reimbursement Manager in Louisiana to support patients and healthcare providers in the reimbursement process. This role involves managing accounts, resolving reimbursement issues, and educating healthcare providers on payer coverage. The ideal candidate will have strong reimbursement experience and excellent communication skills, contributing to the mission of serving patients with serious illnesses.

Benefits

Comprehensive employee benefits package

Discretionary annual bonus

Flexible work models

Qualifications

• Minimum two years of experience in public or private third-party access.
• Strong medical reimbursement experience and/or Specialty Pharmacy knowledge.
• Experience in the healthcare industry including insurance verification and claim adjudication.

Responsibilities

• Manage defined accounts within a specified geographic region.
• Educate and update healthcare providers on key payer coverage.
• Coordinate access/reimbursement issues with relevant partners.

Skills

Medical reimbursement experience

Strong communication skills

Organizational skills

Project management experience

Collaboration skills

Education

Bachelor's degree in business, healthcare, or a related field

Tools

Word

Excel

PowerPoint

Job description

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HOW MIGHT YOU DEFY IMAGINATION?

Join Amgen's Mission of Serving Patients.

At Amgen, if you feel like you're part of something bigger, it's because you are. Our shared mission to serve patients living with serious illnesses drives all that we do.

Since 1980, we've helped pioneer the world of biotech in our fight against the world's toughest diseases. With our focus on four therapeutic areas—Oncology, Inflammation, General Medicine, and Rare Disease—we reach millions of patients each year. As a member of the Amgen team, you'll help make a lasting impact on the lives of patients as we research, manufacture, and deliver innovative medicines to help people live longer, fuller, happier lives.

Our award-winning culture is collaborative, innovative, and science-based. If you have a passion for challenges and the opportunities within them, you'll thrive as part of the Amgen team. Join us and transform the lives of patients while transforming your career.

Tezspire Field Reimbursement Manager (FRM)

Live

What You Will Do

The Tezspire Field Reimbursement Manager (FRM) will manage defined accounts within a specified geographic region in the respiratory therapeutic area. This role involves supporting our products by executing the collaborative territory strategic plan. The FRM will ensure an understanding of the reimbursement process, field reimbursement services, and patient support programs. They will also work on patient-level reimbursement issue resolution, requiring knowledge and experience with patient health information (PHI).

Key Responsibilities

• Act as an extension of the HUB, providing live one-on-one coverage support.
• Offer assistance from physician order to reimbursement, supporting the entire reimbursement journey through payer prior authorization to appeals/denials requirements and forms.
• Review patient-specific information in cases where the site has specifically requested assistance resolving any issues or coverage challenges.
• Educate and update healthcare providers (HCPs) on key private and public payer coverage and changes that impact patient product access.
• Coordinate access/reimbursement issues with relevant partners including the HUB.
• Provide information to HCPs on how the products are covered under the benefit design (Commercial, Medicare, Medicaid).
• Serve as a payer expert for defined geography and promptly communicate payer changes to key stakeholders.
• Offer office education during the access process, including formulary coverage/utilization management criteria, insurance forms & procedures, benefits investigation, prior authorization, appeal, and/or claims resolution.
• Educate offices using approved materials.
• Review patient insurance benefit options and alternate funding/financial assistance programs.
• Collaborate with other departments to resolve reimbursement issues.

Win

What We Expect Of You

We are all different, yet we all use our unique contributions to serve patients.

Minimum Job Qualifications

• Minimum two years of experience in public or private third-party access arena or pharmaceutical industry in managed care, clinical support, and/or sales.
• Strong medical reimbursement experience and/or Specialty Pharmacy and Buy & Bill knowledge.
• Proven presentation and facilitation skills.
• Strong written and oral communication skills.
• Organizational skills and project management experience, including the ability to manage multiple projects.
• Strong computer literacy, including Word, Excel, and PowerPoint, and the ability to conduct web-based meetings.
• Experience in the healthcare industry, including insurance verification, claim adjudication, physician's offices or clinics, pharmacies, and/or pharmaceutical manufacturers.
• Proven experience with hubs and in-depth knowledge of issues related to billing, coding, and appeals across physician types.
• Strong collaboration and ability to lead cross-functional partner meetings.
• Experience with commercial payers, Medicare plans, and state Medicaid in a geographic region.

Preferred Qualifications

• Bachelor's degree in business, healthcare, or a related field.
• Experience with specialty/biologic self-injectable (pharmacy benefit) or physician-administered (buy and bill/medical benefit) products.
• Advanced knowledge of medical insurance terminology.
• Knowledge of Centers of Medicare & Medicaid Services (CMS) policies and processes with expertise in Medicare (Part B for buy & bill products and Part D for Pharmacy products).
• Ability to manage ambiguity and problem-solve.
• Ability to manage expenses within allocated budgets.

Working Conditions

• General office demands. Remote, Work from Home.
• One to two home office days per week.
• Must be able to travel up to 60-70% via automobile or plane.
• Must have a valid driver's license with a clean driving record.
• Possible long periods of sitting and/or keyboard work.

Thrive

What you can expect of us

As we work to develop treatments that take care of others, we also work to care for your professional and personal growth and well-being. From our competitive benefits to our collaborative culture, we'll support your journey every step of the way.

The expected annual salary range for this role in the U.S. (excluding Puerto Rico) is $155,968 to $173,578. Actual salary will vary based on relevant skills, experience, and qualifications.

In addition to the base salary, Amgen offers a Total Rewards Plan, comprising health and welfare plans, financial plans, work/life balance, and career development opportunities, including:

• A comprehensive employee benefits package, including retirement and savings plans, medical, dental, vision coverage, life and disability insurance, and flexible spending accounts.
• A discretionary annual bonus or sales-based incentive plan for field sales reps.
• Stock-based long-term incentives.
• Award-winning time-off plans.
• Flexible work models, including remote and hybrid arrangements.

Apply now

for a career that defies imagination

Objects in your future are closer than they appear. Join us.

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As an organization dedicated to improving the quality of life for people worldwide, Amgen fosters an inclusive environment of diverse, ethical, and highly accomplished people who respect each other and live the Amgen values to continue advancing science to serve patients. We consider all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability status, or any other protected basis. We provide reasonable accommodations for individuals with disabilities during the application and interview process.