Field Retina Reimbursement Strategy Lead

Thea Pharma US; Phoenix (AZ); On-site; USD 200,000 - 230,000; Full time

Benefits offered by this job

Full benefits package

Generous PTO

401(k) match

Job summary

Thea Pharma Inc. is seeking a Field Reimbursement Manager (FRM) – Retina for a field-based role focused on access, reimbursement, and coverage for our retina portfolio.

You will address billing, prior authorizations, and appeals, guiding practices through complex processes without promoting the drug’s clinical benefits. You will partner with Compliance, Finance, Distribution, and Training to align reimbursement strategies and ensure successful execution of launch plans across hospitals, ASCs,

Qualifications

• Bachelor’s degree required; advanced degree or coding certification is a plus.
• 6+ years in pharmaceutical/biotech reimbursement or patient access.
• 6+ years supporting buy-and-bill products in ophthalmology or specialty pharma preferred.
• Launch experience with buy-and-bill in specialty biologics/pipeline space.
• Proficiency with Medicare Part B/ASP models, Part D, commercial insurance, Medicaid, and Hub services.

Responsibilities

• Pre-Launch Account Readiness: run pre-launch and post-launch billing workshops for retina practices.
• J-Code Tracing: educate on new J-code HCPCS codes and ASP transitions.
• Track first-claim success and troubleshoot payer rejections and formatting errors.
• Provide strategic account support on reimbursement, coverage, and access for retina ASCs and hospital departments.
• Educate clinic staff on payer policies, prior authorization, and coding requirements.
• Assist with Buy-and-Bill and specialty pharmacy processes, inventory, and patient assistance programs.
• Track local payer policy rollouts for the new product and relay updates to launch teams.
• Coordinate with Hub to verify benefits and support prior authorizations.
• Collaborate with Field Sales, Key Account Managers, and Patient Support Services to ensure seamless access.

Skills

Launch experience

Ophthalmology/Retina knowledge

Medicare Part B/ASP

Problem solving

Microsoft Office

CRM platforms

Travel 50%

Education

Bachelor’s degree

Advanced degree or coding certification (CPC/CHC/PACs)

6+ years pharma reimbursement experience

Tools

CRM platforms

Excel

PowerPoint

Teams

Job description

Thea Pharma Inc. is seeking a Field Reimbursement Manager (FRM) – Retina for a field-based role focused on access, reimbursement, and coverage for our retina portfolio.

You will address billing, prior authorizations, and appeals, guiding practices through complex processes without promoting the drug’s clinical benefits. You will partner with Compliance, Finance, Distribution, and Training to align reimbursement strategies and ensure successful execution of launch plans across hospitals, ASCs,