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Field Reimbursement Manager - Nashville, TN

BioSpace

Nashville (TN)

Remote

USD 155,000 - 174,000

Full time

3 days ago
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Job summary

A leading biotech company is seeking a Field Reimbursement Manager to guide reimbursement processes for their respiratory products in Nashville, TN. The role covers education for healthcare providers and resolution of patient reimbursement challenges, requiring strong industry knowledge and communication skills.

Benefits

Comprehensive employee benefits package
Generous company contributions to retirement plans
Flexible work models

Qualifications

  • Minimum two years in access arena or pharmaceutical industry.
  • Strong knowledge of reimbursement processes.
  • Experience with specialty/biologic products.

Responsibilities

  • Manage defined accounts in the respiratory therapeutic area.
  • Educate healthcare providers on payer coverage.
  • Resolve patient-level reimbursement issues.

Skills

Medical reimbursement experience
Presentation skills
Organizational skills
Project management
Written communication
Oral communication
Computer literacy
Collaboration
Ability to lead meetings
Payer expertise

Education

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

Tools

Word
Excel
PowerPoint

Job description

Field Reimbursement Manager - Nashville, TN

Join to apply for the Field Reimbursement Manager - Nashville, TN role at BioSpace

Field Reimbursement Manager - Nashville, TN

3 days ago Be among the first 25 applicants

Join to apply for the Field Reimbursement Manager - Nashville, TN role at BioSpace

HOW MIGHT YOU DEFY IMAGINATION?

Join Amgens Mission of Serving Patients

At Amgen, if you feel like youre part of something bigger, its because you are. Our shared missionto serve patients living with serious illnessesdrives all that we do.

Since 1980, weve helped pioneer the world of biotech in our fight against the worlds 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, youll 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 that lay within them, youll 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.


ThriveWhat 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, well 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 several factors including, but not limited to, relevant skills, experience, and qualifications.

In Addition To The Base Salary, Amgen Offers a Total Rewards Plan, Based On Eligibility, Comprising Of Health And Welfare Plans For Staff And Eligible Dependents, Financial Plans With Opportunities To Save Towards Retirement Or Other Goals, Work/life Balance, And Career Development Opportunities That May Include

  • A comprehensive employee benefits package, including a Retirement and Savings Plan with generous company contributions, group medical, dental and vision coverage, life and disability insurance, and flexible spending accounts
  • A discretionary annual bonus program, or for field sales representatives, a sales-based incentive plan
  • Stock-based long-term incentives
  • Award-winning time-off plans
  • Flexible work models, including remote and hybrid work arrangements, where possible


Apply now

for a career that defies imagination

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

careers.amgen.com

In any materials you submit, you may redact or remove age-identifying information such as age, date of birth, or dates of school attendance or graduation. You will not be penalized for redacting or removing this information.

As an organization dedicated to improving the quality of life for people around the world, Amgen fosters an inclusive environment of diverse, ethical, committed and highly accomplished people who respect each other and live the Amgen values to continue advancing science to serve patients. Together, we compete in the fight against serious disease.

Amgen is an Equal Opportunity employer and will consider all qualified applicants for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability status, or any other basis protected by applicable law.

We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. Please contact us to request accommodation.

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