Remote Field Reimbursement Manager - Illinois

Initial Therapeutics, Inc.; Chicago (IL); On-site; USD 145,000 - 197,000; Full time

Benefits offered by this job

Retirement plan

Medical, dental & vision coverage

Life insurance

Stock-based incentives

Discretionary bonus

Flexible work arrangements

Job summary

Amgen is seeking a Field Reimbursement Manager to cover Illinois and support Patient Access and Reimbursement initiatives. You will drive the territory strategy, partner with HUB, and ensure payer processes are navigated from prior authorization to appeals.

The role requires leadership, deep reimbursement knowledge, and the ability to educate healthcare providers on coverage options across Commercial, Medicare, and Medicaid.

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.

Responsibilities

• 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

Skills

Healthcare payer knowledge

Project management

Leadership experience

Communication skills

Multi-tasking

Geography knowledge Illinois

Education

Doctorate degree

Master's degree + 3 years experience

Bachelor's degree + 5 years experience

Associate degree + 10 years experience

High school diploma + 12 years experience

Job description

Amgen is seeking a Field Reimbursement Manager to cover Illinois and support Patient Access and Reimbursement initiatives. You will drive the territory strategy, partner with HUB, and ensure payer processes are navigated from prior authorization to appeals.

The role requires leadership, deep reimbursement knowledge, and the ability to educate healthcare providers on coverage options across Commercial, Medicare, and Medicaid.