Field Reimbursement Manager

Updated: June 10, 2024
Location: Charlotte, NC, United States
Job ID: 4639-OTHLOC-Ch5wYfwA

 

 

 

 

Description

You’re an expert facilitator: you open doors, foster communication and bridge the gap Syneos Health.

Problem solving and connecting people with the information they need is your forte. You’re a unifier by nature and you’re at your best when setting others up for success. Your ability to clear the way, extrapolate intricate details, attend to complex situations and serve as a trusted go-between make you a perfect fit for a Field Reimbursement Manager role at Syneos Health. The Field Reimbursement Manager will be responsible for the management of defined accounts in a specified geographic region in the GI therapeutic area, specifically supporting our client’s product. The Field Reimbursement Manager will execute the collaborative territory strategic plan through partnership with internal and external stakeholders, including acting as an extension of patient support program and in other collaboration with other partners. Responsibilities include ensuring understanding of Reimbursement and program support program as it relates to the product. The Reimbursement Manager will also work on patient level reimbursement issue resolution, and thus will need access to be knowledge of and have had experience with patient health information (PHI).

Services and Activities Provided by Reimbursement Managers:

Field Reimbursement Managers manage daily activities that support appropriate patient Reimbursement to our client's products in the provider offices and work as a liaison to other patient support programs offered by our client. Activities may include, but are not limited to:

  • Provide in-person or virtual one-on-one support to address questions about coverage requirements
  • Support patient access assistance from prescriber decision through to fulfillment, supporting the entire Reimbursement journey through payer prior authorization to appeals/denials requirements procedures and forms
  • Reviewing patient-specific information in cases where the site has specifically requested the assistance and patient health information is available in resolving any issues or coverage challenges
  • Reviewing patient insurance benefit options, in cases where patient health information is available as a result of patient hub enrollment 
  • Coordinating with other patient support service program representatives and with the field sales force, if necessary
  • Educating physician office staff on the use of the patient assistance programs and call center support services, including web based provider programs
  • Provide information on relevant Reimbursement topics related to the client product
  • Serve as payer expert for defined geography and able to communicate changes to key stakeholders in a timely manner

Along with demonstrated initiative, resourcefulness and a results-oriented mindset, the ideal candidate has:

  • Bachelor’s degree required
  • Minimum three years’ experience in public or private third-party Reimbursement arena or pharmaceutical industry in managed care, clinical support, or sales.
  • Experience with specialty products acquired through Specialty Pharmacy networks
  • Experience working with patient support programs
  • Preferred Experience with buy and bill process including coding, coverage, and reimbursement  
  • Preferred GI experience 
  • Experience building relationships within an account by working closely with them to navigate Reimbursement barriers to specialty products for their patients
  • Ability to operate as a “team player” in compliant collaboration collaborating with multiple sales representatives, sales leadership, and internal colleagues to reach common goals
  • Knowledge of Centers of Medicare & Medicaid Services (CMS) policies and processes with expertise in Medicare Part D (Pharmacy Benefit design and coverage policy) a plus
  • Knowledge of Managed Care, Government, and Federal payer sectors, as well as Integrated Delivery Network/Integrated Health Systems a plus
  • Ability to travel and cover large multistate geography territories, at least 50% travel required, based on geography and territory accounts 
  • Advanced knowledge of medical insurance terminology
  • Ability to manage expenses within allocated budgets
  • Ability to travel and possess a valid driver’s license to drive to assigned healthcare accounts, unless otherwise specified
  • Must live within territory or within territory boundaries.

At Syneos Health, we are dedicated to building a diverse, inclusive and authentic workplace. If your past experience doesn’t align perfectly, we encourage you to apply anyway. At times, we will consider transferable skills from previous roles. We also encourage you to join our Talent Network to stay connected to additional career opportunities.

Why Syneos Health? Our ability to collaborate and problem-solve makes a difference in patients’ lives daily. By joining one of our field access teams, you will partner with industry experts and be empowered to succeed with the support, resources, and autonomy needed to successfully navigate the complex reimbursement landscape. The diversification and breadth of our new and existing partnerships create a multitude of career paths and employment opportunities. Join our game-changing, global company dedicated to creating better, smarter, faster ways to get biopharmaceutical therapies to patients Experience the thrill of knowing that your everyday efforts are contributing to improving patients’ lives around the world. 

Wor Her Matter Everywher | How are you inspired to change lives?

Syneos Health companies are affirmative action/equal opportunity employers (Minorities/Females/Veterans/Disabled)

Syneos Health has a voluntary COVID-19 vaccination policy. We strongly encourage all employees to be fully vaccinated. Additionally, certain local governments or Syneos Health customers may have vaccine requirements that apply to some of our employees. These employees are required to submit proof of vaccination to Syneos Health and maintain compliance with these requirements.
At Syneos Health, we believe in providing an environment and culture in which Our People can thrive, develop and advance. We reward and recognize our people by providing valuable benefits and a quality-of-life balance. The benefits for this position will include a competitive compensation package, Health benefits to include Medical, Dental and Vision, Company match 401k, flexible paid time off (PTO) and sick time. Because certain states and municipalities have regulated paid sick time requirements, eligibility for paid sick time may vary depending on where you work. Syneos Health complies with all applicable federal, state, and municipal paid sick time requirements.



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