Field Reimbursement Manager

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Updated: Yesterday
Location: Denver, CO, United States
Job ID: 6536

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Overview

You provide the vision, set the pace and inspire success.

There’s one thing you do that’s exceptional: lead. You formulate a plan and focus your team to solve the unsolvable, beat the unbeatable and come out on top. Your capacity to creatively strategize, motivate Field Reimbursement Managers, and elicit success makes you the right fit for a Field Reimbursement Director role with Syneos Health.

 

Responsibilities

Reimbursement managers manage daily activities that support appropriate patient Reimbursement to products in the provider offices and work as a liaison to other patient assistance and Reimbursement support services. Activities include, but are not limited to:

  • Provide live one-on-one support to address questions about coverage requirements
  • Offer assistance from prescriber decision through to access, 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 SRF
  • 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 product
  • Serve as payer expert for defined geography and able to communicate changes to key stakeholders in a timely manner

Job Requirements

Along with a results-oriented mindset, keen attention to detail and an encouraging manner, 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 with coding, billing and in office support programs
  • Specialty pharmacy experience required (ability to teach an office the entire process from script to injection)
  • Establishing relationships within a practice by working closely with them to help remove Reimbursement barriers to specialty products for their patients
  • Ability to operate as a “team player” in 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 / targeting make up
  • Advanced knowledge of medical insurance terminology
  • Ability to manage expenses within allocated budgets
  • Ability to schedule individual work related travel (air, hotel, rental car as needed)
  • Above average computer skills: PowerPoint, Excel, Word, CRM (Salesforce.com)
  • Understanding of patient privacy laws including HIPAA and similar state laws
  • Ability to travel and possess a valid driver’s license to drive to assigned healthcare accounts, unless otherwise specified

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.

Why Syneos Health? Join a game-changing global company that is reinventing the way therapies are developed and commercialized. Here, you’re essential in solving and executing against today’s toughest commercialization challenges facing the world’s leading healthcare companies. From the very beginning, you’ll be supported by team members who, like you, aren’t afraid to try something new. You'll gain exposure and work in a dynamic environment to create better, smarter, faster ways to get biopharmaceutical therapies to patients.


WORK HERE MATTERS EVERYWHERE | How will you accelerate bringing Market Access solutions to clients?

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


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