Regional Safety Manager developing and administering environmental, health, and safety programs at MiTek. Responsible for safety risk identification and training facilitation in manufacturing environments.
About the role
- Field Reimbursement Manager managing patient access in defined geographic region for a biotechnology company. Supporting products and ensuring understanding of reimbursement processes and patient support programs.
Responsibilities
- Manage defined accounts within a specified geographic region for Patient Access and Reimbursement
- Support products by executing the collaborative territory strategic plan
- Ensure an understanding of the reimbursement process, field reimbursement services, and patient support programs
- Work on patient-level reimbursement issue resolution, requiring knowledge and experience with patient health information (PHI)
- Act as an extension of the HUB, providing live one-on-one coverage support
- Offer assistance from physician order to reimbursement, supporting the entire reimbursement journey through payer prior authorization to appeals/denials requirements and forms
- Review patient-specific information in cases where the site has specifically requested assistance resolving any issues or coverage challenges
- Educate and update healthcare providers (HCPs) on key private and public payer coverage and changes that impact patient product access
- Coordinate access/reimbursement issues with relevant partners, including the HUB
- Provide information to HCPs on how the products are covered under the benefit design (Commercial, Medicare, Medicaid)
- Serve as a payer expert for defined geography and promptly communicate payer changes to key stakeholders
- Offer office education during the access process, including formulary coverage/utilization management criteria, insurance forms & procedures, benefits investigation, prior authorization, appeal, and/or claims resolution
- Educate offices using approved materials
- Review patient insurance benefit options and alternate funding/financial assistance programs
- Collaborate with other departments to resolve reimbursement issues
Requirements
- Doctorate degree OR Master’s degree and 3 years of customer service and/or leadership experience OR Bachelor’s degree and 5 years of customer service and/or leadership experience OR Associate’s degree and 10 years of customer service and/or leadership experience OR High school diploma / GED and 12 years of customer service and/or leadership experience
- Minimum two years of experience in public or private third-party access arena or pharmaceutical industry in managed care, clinical support, and/or sales
- Strong medical reimbursement experience and/or Specialty Pharmacy and Buy & Bill knowledge
- Proven presentation and facilitation skills
- Strong written and oral communication skills
- Organizational skills and project management experience, including the ability to manage multiple projects
- Strong computer literacy, including Word, Excel, and PowerPoint, and the ability to conduct web-based meetings
- Experience in the healthcare industry, including insurance verification, claim adjudication, physician's offices or clinics, pharmacies, and/or pharmaceutical manufacturers
- Proven experience with hubs and in-depth knowledge of issues related to billing, coding, and appeals across physician types
- Experience with commercial payers, Medicare plans, and state Medicaid in a geographic region
- Live in the geography or less than 10 miles from the geography border
Benefits
- A comprehensive employee benefits package, including a Retirement and Savings Plan with generous company contributions
- group medical, dental and vision coverage
- life and disability insurance
- flexible spending accounts
- A discretionary annual bonus program, or for field sales representatives, a sales-based incentive plan
- Stock-based long-term incentives
- Award-winning time-off plans
- Flexible work models, including remote and hybrid work arrangements, where possible
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