About the role

Field Reimbursement Manager educating healthcare providers on product-specific prior authorization and appeals processes. Collaborating with client and Inizio Engage Patient Solutions to improve patient access.

Responsibilities

Educate HCPs and appropriate office staff about product specific prior authorization & appeals process, how to access related forms, and high-level information about submission procedures and reauthorization requirements.
Work with in-network Specialty Pharmacies on cases where the patient has provided consent.
Educate HCPs and appropriate office staff on specific referral processes and patient assistance programs.
Work closely with sales and other matrix partners to identify additional accounts with need for education.
Utilize approved resources and FAQs to provide education and answer questions as needed.
Solid understanding of reimbursement issues that work within our core classes of trade: Commercial Managed Care (Regional Plans), Medicaid (Fee for Service, Managed Care Organizations), Medicare (Part A, B, C, D; Carriers), Veteran’s Administration (VISNs), TRICARE Regional Offices, Specialty Pharmacy & Pharmacy Benefit Managers, ACOs and other Integrated Delivery Networks (IDNs), Advocacy, consumer, provider and treatment systems groups.
Document interaction details within CRM with attention to data integrity to ensure compliance with program policies and business rules.
Maintain confidentiality of Patient Health Information (PHI) and act in compliance with all laws, regulations, and company policies.
Adhere to all Inizio and client policies, procedures, business rules, and call guides, as well as applicable laws.

BS/BA required.
3+ years of relevant experience in – reimbursement and patient access, market access, specialty pharmacy, or physician/system account management.
Proven success operation in a field-based role
Experience in endocrine or men’s health disorders preferred.
Strong knowledge and understanding of payer reimbursement models (medical and pharmacy), prior authorization and appeal requirements, coding changes, appropriate claim submission, integration of HUB and patient assistance programs
Maintains compliance with program business rules, standard operating procedures and guidelines
Highly organized with excellent attention to detail and the ability to multi-task in engaging both patients and providers.
Passionate about learning and able to share/communicate that passion to others.
Experience engaging HCP staff in a support role to educate on access pathways and product requirements.
Experience navigating payer reimbursement process, preferably Medicare Part D (pharmacy benefit design and coverage policy).

Competitive compensation
Excellent Benefits – accrued time off, medical, dental, vision, 401k, disability & life insurance, paid maternity and paternity leave benefits, employee discounts/promotions
Employee discounts & exclusive promotions
Recognition programs, contests, and company-wide awards
Exceptional, collaborative culture
Best Places to Work in BioPharma (2022, 2023, & 2024)
Certified Great Place to Work (2022, 2023, 2025)