Field Reimbursement Manager - Newark, NJ

1002 Amgen USA Inc.; Newark (NJ); Hybrid; USD 145,000 - 197,000; Full time

Job summary

Amgen Inc. in Newark, New Jersey is seeking a Field Reimbursement Manager to manage defined accounts within a geographic region, focusing on patient access and reimbursement. You will drive payer strategies, educate HCPs on coverage options, and work with HUB to resolve reimbursement challenges.

This role requires deep knowledge of CMS/Medicare/Medicaid policies, strong communication and project management skills, and a collaborative, patient-centric approach. Significant travel is involved.

Qualifications

• PhD or Master's with 3+ years of customer service/leadership experience, or equivalent Bachelor's with 5+ years.
• Experience managing people and leading teams, projects, or resources.
• Strong written and oral communication skills and collaboration abilities.

Responsibilities

• Manage defined accounts within geographic region for patient access and reimbursement.
• Educate HCPs on payer coverage and changes that impact patient access.
• Coordinate with HUB and cross-functional teams to resolve reimbursement issues.
• Assist in payer prior authorization, appeals/denials, and benefits investigation.
• Travel up to 60-80% as required.

Skills

Payer policies

Medical reimbursement

Stakeholder management

Presentation skills

Communication skills

Project management

Travel ability

Education

Doctorate degree

Master's degree

Bachelor's degree

Associate's degree

High school diploma

Tools

Word

Excel

PowerPoint

Job description

Career Category Sales Job Description This role will be supporting the Respiratory business unit. Relocation not included for this role. 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. Amgen is advancing a broad and deep pipeline and portfolio of medicines to treat heart disease, obesity and obesity-related conditions, rare diseases, inflammatory conditions and cancer. 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 that lay within them, you’ll thrive as part of the Amgen team. Join us and transform the lives of patients while transforming your career.

Field Reimbursement Manager - Newark, New Jersey

What you will do

Let’s do this. Let’s change the world. In this vital role the Field Reimbursement Manager (FRM) will manage defined accounts within a specified geographic region for Patient Access and Reimbursement. This role involves supporting 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). 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

Working Conditions

3 days a week in geography for customer appointments, (geography specific) General office demands – Remote, Work from Home. One to two home office days per week. Must be able to travel up to 60-80% 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.

What we expect of you

We are all different, yet we all use our unique contributions to serve patients. The field reimbursement professional we seek is a collaborator with these qualifications.

Basic Qualifications

• Doctorate degree OR Master’s degree and 3 years of customer service and/or leadership experience OR Bachelor’s degree and 5 years of customer service and/or leadership experience OR Associate’s degree and 10 years of customer service and/or leadership experience OR High school diploma / GED and 12 years of customer service and/or leadership experience
• In addition to meeting at least one of the above requirements, you must have experience directly managing people and/or leadership experience leading teams, projects, programs, or directing the allocation or resources. Your managerial experience may run concurrently with the required technical experience referenced above.

Preferred Qualifications

• 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
• Live in the geography or less than 10 miles from the geography border
• Bachelor's degree in business, healthcare, or a related field
• 6 years' 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
• 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

What you can expect of us

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 posted. 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 where possible. Refer to the Work Location Type in the job posting to see if this applies.

Sponsorship

Sponsorship for this role is not guaranteed.

Amgen is an Equal Opportunity Employer

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. Amgen is an Equal Opportunity employer and will consider you without regard to your race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, or disability status.

Salary Range 145,470.70USD -196,813.30 USD

Amgen is committed to unlocking the potential of biology for patients suffering from serious illnesses by discovering, developing, manufacturing and delivering innovative human therapeutics. This approach begins by using tools like advanced human genetics to unravel the complexities of disease and understand the fundamentals of human biology. Amgen focuses on areas of high unmet medical need and leverages its biologics manufacturing expertise to strive for solutions that improve health outcomes and dramatically improve people's lives. A biotechnology pioneer since 1980, Amgen has grown to be one of the world's leading independent biotechnology companies, has reached millions of patients around the world and is developing a pipeline of medicines with breakaway potential. For more information, visit www.amgen.com and follow us on www.twitter.com/amgen

Application deadline Amgen does not have an application deadline for this position; we will continue accepting applications until we receive a sufficient number or select a candidate for the position. Sponsorship