Hybrid Field Reimbursement Manager

Posted 6 days ago

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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.

Requirements

  • 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).

Benefits

  • 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)

Job title

Field Reimbursement Manager

Job type

Experience level

Mid levelSenior

Salary

Not specified

Degree requirement

Bachelor's Degree

Location requirements

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