Field Reimbursement Manager - Newark, NJ

Amgen; Newark (NJ); Hybrid; USD 90,000 - 130,000; Full time

Benefits offered by this job

Stock-based long-term incentives

Retirement and Savings Plan

Health, dental and vision coverage

Flexible work models

Job summary

Amgen is seeking a Field Reimbursement Manager in Newark, New Jersey to manage defined accounts and execute territory strategic plans for patient access and reimbursement. The role covers payer prior authorizations, denials, and appeals, with travel up to 60-80% and a strong emphasis on educating healthcare providers about coverage changes.

The FRM will collaborate with HUB and other departments to resolve reimbursement issues, support patient access programs, and communicate payer changes

Qualifications

• Doctorate, Master’s, Bachelor’s, Associate’s or High School with leadership experience.
• Experience directly managing people and/or leading teams, projects, or programs.

Responsibilities

• Act as an extension of the HUB and provide live coverage support.
• Assist from physician order to reimbursement through the entire reimbursement journey.
• Educate healthcare providers on payer coverage changes that impact access.
• Coordinate access/reimbursement issues with the HUB and other departments.
• Inform offices on product coverage under different benefit designs (Commercial, Medicare, Medicaid).

Skills

Regulatory knowledge

Communication skills

Collaboration

Problem solving

Leadership

Education

Doctorate degree

Master’s degree

Bachelor’s degree

Associate’s degree

High school diploma

Tools

MS Office (Word, Excel, PowerPoint)

Job description

Join Amgen’s Mission of Serving Patients

This role will be supporting the Respiratory business unit.

Relocation not included for this role.

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

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 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.

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.

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

Sponsorship for this role is not guaranteed.

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

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.