Job Description

Job Title: Field Reimbursement Manager

Location: Hybrid in Plainsboro, NJ

Pay Rate: Open to discuss (This is a contract role)

Duration: 06 - 12 months contract

PURPOSE:

• The Field Reimbursement Manager (FRM) is a field-based employee who provides limited support to HCPs and their staff to help facilitate appropriate patient access to prescribed products.
• The role of the FRM is to create awareness with HCPs and their staff about the patient support program and to respond appropriately to HCPs and their staff about questions regarding coverage, reimbursement and patient access issues for products. The FRM does not promote products or otherwise seek to influence prescribing decisions.
• The FRM is responsible for field-based account planning and performing patient access initiatives as directed by FRM management and in accordance with all applicable policies and procedures.
• The FRM will be an expert in local, state and regional payer policies for products and will educate HCP offices regarding such policies

RELATIONSHIPS:

• Reporting to the Sr. Director, RD Patient Solutions, the FRM will implement patient access initiatives at the physician practice level in order to facilitate appropriate patient access to products.
• The FRM may collaborate appropriately with other field-based personnel, such as sales and Market Access Account Executives, to facilitate appropriate patient access. This may include sharing high-level updates on product coverage and reimbursement trends/payer policies and requirements, but FRMs may not discuss any specific patient case or office issues with any such personnel.
• The successful candidate will build and maintain positive and appropriate relationships with internal colleagues and HCP offices in order to facilitate product access.

ESSENTIAL FUNCTIONS:

• Facilitate appropriate reimbursement and support HCP processes for timely patient care and access
• Reads, monitors and analyses data to identify patient access requirements, potential payer trends. and specialty pharmacy performance issues and positively communicates knowledge to appropriate personnel and takes appropriate action to facilitate access as needed.
• Provide high-level updates and education on payer coverage policies to HCPs and their office staff and internal personnel,
• Work closely to facilitate complete, accurate and timely benefits investigation and provide prior authorization and appeals support, as requested.
• Recommend best practices to management team and implement those best practices as appropriate
• Share best practices with FRM colleagues.
• Advise colleagues on long and short-range changes in the coverage and reimbursement policies under Medicare, Medicaid, commercial payers and plans that may impact product coverage
• Manage their own budget
• Successfully manage other projects as directed with proven results

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