Field Reimbursement Manager- Portland, OR

Amgen; Portland (OR); Híbrido; USD 145 000 - 197 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Retirement savings plan

Medical, dental and vision coverage

Generous time-off and flexible work

Resumo da oferta

Amgen invites a Field Reimbursement Manager to join the Portland, OR team. You will cover Oregon, Idaho, Santa Rosa, CA, and Redding, CA, ensuring smooth reimbursement workflows and collaborating with payers and healthcare providers.

You will educate providers on coverage changes, navigate prior authorizations, and drive access strategies across commercial and government plans. This role requires strong leadership, communication, and project management.

Qualificações

• 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.
• Experience directly managing people and/or leadership experience leading teams, projects, programs, or directing resources.

Responsabilidades

• Understand reimbursement processes and patient support programs.
• Assist with patient-level reimbursement issue resolution and PHI knowledge.
• Serve as an extension of the HUB, providing live coverage support.
• Guide reimbursement journey from physician order to payer authorization and appeals.
• Review patient information and assist with coverage challenges as needed.
• Educate healthcare providers on payer coverage changes affecting access.
• Coordinate access issues with HUB and other partners.
• Explain product coverage under Commercial, Medicare, and Medicaid.
• Act as payer expert for defined geography and communicate changes to stakeholders.
• Educate offices using approved materials and assist with benefits investigation and prior authorization.

Conhecimentos

Communication skills

Presentation skills

Project management

Organizational skills

Team leadership

Formação académica

Doctorate or Master’s + leadership experience

Bachelor’s or higher in health/related field

Ferramentas

Word

Excel

PowerPoint

Descrição da oferta de emprego

Field Reimbursement Manager

Portland, OR – Territory Covers: Oregon, Idaho, Santa Rosa, CA & Redding, CA

Career Category Sales & Marketing Operations Job Description Field Reimbursement Manager - Portland, OR Territory Covers: Oregon, Idaho, Santa Rosa, CA & Redding, CA

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. Amgen is advancing a broad and deep pipeline of medicines to treat cancer, heart disease, inflammatory conditions, rare diseases, and obesity and obesity-related conditions. 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.

What you will do

• 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

Work Conditions

2 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 40% 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

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

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
• Live in the geography or less than 10 miles from the geography border

Preferred Qualifications

• 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

Benefits

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.

Salary Range 145,470.70USD -196,813.30 USD

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 for this role is not guaranteed.

Amgen is an Equal Opportunity employer. We make all employment decisions without regard to race, color, religion, sex or any other characteristic protected by applicable law. We provide reasonable accommodations to applicants and employees with disabilities, consistent with legal requirements. Please contact us to request accommodation.

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