Territory Access & Reimbursement Manager

Jobtailor; San Francisco (CA); On-site; USD 120,000 - 160,000; Full time

Job summary

Jobtailor in San Francisco seeks a Field Reimbursement Manager to serve as a dedicated access and reimbursement resource within an assigned territory. You will educate provider offices on payer requirements, reimbursement processes, patient support services, and approved access resources.

Develop and execute a territory access plan, coordinate with sales, hub partners, and cross-functional teams, and document activities in the CRM.

Qualifications

• 3+ years of experience in Managed Care, Field Reimbursement, Patient Services, Specialty or Biologics Sales, or healthcare provider office practice management
• 4-year degree in related field or equivalent experience
• Cardiovascular/Cardiology and Hospital Healthcare Systems experience a plus
• Ability to travel 3-4 days a week, with overnights as needed, and reside within the Territory
• Solution-oriented mindset, strong business acumen, and strong analytic capabilities
• Experience and understanding of Retail Pharmacies and Specialty Pharmacies
• Demonstrated ability to educate offices on access processes and issue resolution
• Experience educating HCPs and office staff on client-specific Patient Service programs, such as copay programs
• Experience delivering educational presentations in person and/or via Zoom, Webex, or Teams
• Advanced knowledge of medical insurance terminology
• Knowledge of CMS policies and processes, with expertise in Medicare Part D for Pharmacy Benefit products
• Ability to develop and maintain trusted relationships with internal partners and work effectively in teams
• Ability to manage ambiguity and problem solve
• Ability to prepare and submit appropriate expense reports in a timely fashion
• Valid Driver’s License

Responsibilities

• Serve as a dedicated access and reimbursement resource within an assigned territory
• Educate provider offices and staff on payer requirements, reimbursement processes, patient support services, and approved access resources
• Support appropriate patient access for client products and resolve access issues
• Develop and execute a territory access plan and prioritize accounts
• Coordinate with sales, market access, patient services, hub/specialty pharmacy partners, and other stakeholders
• Document activities in the approved CRM platform
• Provide education on prior authorizations, appeals, denials, and formulary criteria
• Conduct in-person customer visits and participate in client and cross-functional meetings
• Monitor payer policy, formulary coverage, and denial patterns to identify barriers
• Communicate payer changes and field insights to internal stakeholders
• Provide education on coding, forms, benefits investigation, and claims resolution
• Identify field access insights and reimbursement challenges
• Report adverse events and other required information

Skills

Managed Care

Field Reimbursement

Patient Services

HCP Education

Analytics

Relationship Building

Presentations

Travel Ready

Education

Bachelor's degree

Tools

CRM Platform

Zoom

Webex

Microsoft Teams

Job description

Jobtailor in San Francisco seeks a Field Reimbursement Manager to serve as a dedicated access and reimbursement resource within an assigned territory. You will educate provider offices on payer requirements, reimbursement processes, patient support services, and approved access resources.

Develop and execute a territory access plan, coordinate with sales, hub partners, and cross-functional teams, and document activities in the CRM.