Remote Field Reimbursement Leader: Payer Strategy & Access

VetJobs; Hartford (CT); On-site; USD 145,000 - 197,000; Full time

Job summary

Amgen Hartford is seeking a Field Reimbursement Manager to oversee defined accounts within a specified geographic region, driving access and reimbursement strategies for patient access programs. You will liaise with healthcare providers, HUB teams, and payer partners to ensure timely coverage and resolution of reimbursement issues.

The role requires experience in medical reimbursement, strong communication, and leadership skills, with travel up to 40% and on-site work in Hartford, CT.

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
• 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
• Live in geography or within 10 miles of border
• Bachelor's degree in business, healthcare, or related field
• 6 years' experience with specialty/biologic self-injectable or physician-administered products
• Advanced knowledge of medical insurance terminology
• CMS policies and processes expertise (Medicare Part B and Part D)
• Ability to manage ambiguity and problem-solve
• Ability to manage expenses within allocated budgets
• Experience in healthcare industry including insurance verification, claim adjudication, offices or clinics, pharmacies, and manufacturers

Responsibilities

• Manage defined accounts within a geographic region for Patient Access and Reimbursement
• Support products by executing the territory strategic plan
• Understand reimbursement processes, field reimbursement services, and patient support programs
• Resolve patient-level reimbursement issues and know PHI handling
• Educate healthcare providers on payer coverage and changes
• Coordinate access/reimbursement issues with partners including HUB
• Inform on product coverage under Commercial, Medicare, Medicaid
• Act as payer expert for defined geography and communicate payer changes
• Provide office education during access process (forms, prior authorization, appeals)
• Educate offices using approved materials
• Review patient insurance benefits and alternate funding programs
• Collaborate with other departments to resolve issues

Skills

Public access experience

Medical reimbursement knowledge

Leadership experience

Project management

Presentation skills

Strong communication

Patient access knowledge

Hub knowledge

Web meetings

MS Word

MS Excel

MS PowerPoint

Education

Doctorate degree

Master’s degree

Bachelor’s degree

Associate’s degree

High school diploma / GED

Tools

Word

Excel

PowerPoint

Job description

Amgen Hartford is seeking a Field Reimbursement Manager to oversee defined accounts within a specified geographic region, driving access and reimbursement strategies for patient access programs. You will liaise with healthcare providers, HUB teams, and payer partners to ensure timely coverage and resolution of reimbursement issues.

The role requires experience in medical reimbursement, strong communication, and leadership skills, with travel up to 40% and on-site work in Hartford, CT.