Must run an MVR
80% travel within a territory (DC/Arlington, VA)
Field Reimbursement Manager:
The Field Reimbursement Manager (FRM) is responsible for managing an assigned territory focused on supporting specific drug (including Benefit Investigation, Prior Authorization, Claims Assistance, and Appeals) and educating the office on Payer landscape and services available through both remote interaction and on-site training.
This position is client facing and customer-facing and requires the ability to build relationships with physician offices as well as manufacture representatives to effectively deliver services based on customer specific preferences.
The Field Reimbursement Manager works independently in a fast paced, highly visible environment as well as collaboratively with the internal program hub support services to ensure all customer needs are met.
FRM will frequently interact via telephone with providers and internal staff to arrange site visits, Manufacturer trainings, and educational training venues.
Must have a solid working knowledge of Medicare and Commercial insurance plans and benefit structures in order to relay detailed benefit information and maximize the customer experience.
Position will require travel, project management and/or account coordination based on client expectation.
Key Responsibilities
1. Act as a strategic reimbursement advisor and primary liaison for healthcare providers, proactively identifying and resolving complex access and reimbursement barriers for assigned therapies.
2. Lead the resolution of high-impact reimbursement cases by overseeing benefit investigations, prior authorizations, claims escalations, and appeals, ensuring timely patient access.
3. Design and deliver advanced payer insights tailored to provider needs, incorporating evolving policy trends and access strategies across remote and in-person platforms.
4. Cultivate and expand strategic partnerships with key provider offices and manufacturer stakeholders to align support services with evolving customer and market dynamics.
5. Drive cross-functional collaboration with internal hub operations, analytics, and client teams to optimize service delivery and elevate the provider and patient experience.
6. Plan and facilitate high-value site engagements, including manufacturer-sponsored training and regional educational forums, to enhance provider readiness and adoption.
7. Serve as a subject matter expert on Medicare and commercial payer structures, translating complex benefit data into actionable insights for stakeholders.
8. Represent the FRM function in field-based initiatives, territory planning, and stakeholder engagement strategies to maximize visibility and impact.
9. Oversee territory-level project execution and account coordination, ensuring alignment with client KPIs, compliance standards, and program milestones.
10. Operate with a high degree of autonomy in a dynamic, client-facing environment, consistently delivering results under tight timelines and shifting priorities.
11. Lead documentation and reporting of all field activities in the FRM CRM system, ensuring data integrity and visibility for internal and client stakeholders.
Minimum Job Qualifications Education/Training:
• 4-year degree in related field or equivalent experience Business Experience:
• Entry-level experience in project management
• Minimum of 8 years healthcare related reimbursement experience
• Strong medical reimbursement experience with Buy & Bill and/or Specialty Pharmacy.
• Experience supporting program specific drug therapy space, i.e., oncology, dermatology, etc.
• Experience in the healthcare industry including, but not limited to insurance verification, prior authorizations, and/or claim adjudication, physician’s office or clinics.
• Must have Medicare and commercial insurance coverage experience.
• Must be able to deliver and document benefit investigation outcomes and relay status reports on a regularbasis.
• Strong customer service experience
• Proven presentation skills and experience
• Ability to effectively handle multiple priorities within a changing environment.
• Excellent organizational skills
• Strong Computer literacy to include PowerPoint and Web Meeting experience. Specialized
Knowledge/Skills:
• Previous field experience, a plus
• Previous experience with specialty pharmacy a plus
• Account management experience, a plus
• Excellent Interpersonal skills.
• Excellent written and oral communication skills.
• Problem solving and decision-making skills.
...Job Description Job Description We are lookingto hire an Office Manager to join our team! You will be responsible for overseeing the administrative activities of the organization. Responsibilities: Manage records and information Plan and maintain work facilities...
...A remote survey panel organization is seeking a Data Entry Clerk for an entry-level position. This role allows you to work from home with maximum flexibility and earn extra income. Ideal candidates are self-motivated individuals who enjoy data entry tasks and can follow...
...could have on the food service industry. There's a seat at our table for you... 2nd Shift Warehouse Package Handler Distribution Center Address: 225 Solar Dr., Imperial, PA Pay: Starting at $20.55/hour ~ Plus, earn two pay raises in your first year...
...leader in blood health dedicated to improving patient outcomes through precision medicine and transfusion science. As a Medical Laboratory Scientist, youll perform critical immunohematology testing and ensure the safe and accurate provision of blood products for transfusion...
...Description Job Description Active Licensed Practical Nurse (LPN) license and minimum 1+ years Licensed Practical Nurse (LPN)... ...or Licensed Vocational Nurse (LVN) credentials is sought for a contract assignment supporting K-12 students in a school district setting...