Field Reimbursement Manager, Patient Access & Payer Coverage
Overview
You will own reimbursement, access, and coverage strategy for assigned products in the Dallas territory. As the Field Reimbursement Manager, you bridge gaps between patients, providers, and payers. You will analyze access barriers, educate on the patient journey, and coordinate with HUB services and specialty pharmacies. This role stands apart with deep dives into payer policies and direct impact on patient access.
What You'll Do7
- 1Analyze access and reimbursement issues to identify barriers and opportunities for assigned products.
- 2Educate office personnel on the patient journey, covering enrollment forms, prior authorization, and appeals.
- 3Provide reimbursement expertise to field teams, including coding, coverage, and payment across all sites of care.
- 4Coordinate with HUB and patient support services for seamless access, and liaise with specialty pharmacies for pharmacy benefit products.
- 5Train healthcare providers on claims submissions, billing procedures, and payer coding requirements.
- 6Inform providers on product coverage under benefit design and educate on public and private payer policy changes.
- 7Navigate peer-to-peer interventions and support appeals processes to secure patient access.
Requirements8
- 1Bachelor's degree required.
- 25+ years in pharmaceutical or biotech, plus 2+ years in patient journey navigation, payer, reimbursement, medical billing & coding, or specialty pharmacy.
- 3In-depth understanding of patient enrollment forms, prior authorization, appeals, and peer-to-peer interventions.
- 4Knowledge of coding, coverage, and payment across office, clinic, and hospital settings.
- 5Live within the Dallas territory or its boundaries.
- 6Buy and bill product experience preferred.
- 7Experience in rheumatology, dermatology, gastroenterology, or neurology preferred.
- 8Immunology experience with self-injection specialty pharmacy products preferred.
Salary Insight
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