Field Reimbursement Manager

Overview

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

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.

Responsibilities

The Field Reimbursement Manager (FRM) will operate as the subject-matter expert on reimbursement, access, and coverage issues affecting the clients products. Educate HCPs and their staff on matters related to reimbursement, access and coverage to facilitate appropriate patient access. The FRM will analyze reimbursement and access issues and act as the local access and reimbursement resource for other field sales force personnel and region management. Coordinate with the Hub concerning individual patient cases including patient reimbursement assistance, referrals to enrollment, and overall coordination. The FRM will need to collaborate cross functionally with Field Sales, Marketing, Market Access, Public Affairs, State & Government Affairs, Trade, and Specialty Pharmacy Accounts while abiding by all corporate and industry policy and procedures.

You will: 

• Analyze reimbursement issues and opportunities
• Provide offices product reimbursement expertise
• Provide reimbursement education to field teams etc.
• Coordinate on reimbursement issues with third parties including Hubs
• Liaising with Specialty Pharmacy for pharmacy benefit products
• Educate HCPs on reimbursement processes claims submissions, procedures and coding requirements of payer organizations (local payers, government payers, etc.)
• Provide information to HCP on how the products are covered under the benefit design (Commercial, Medicare Part D, Medicaid)
• Answer questions about coverage, ICD-10 codes of product, including patient-specific access questions
• Educate and update HCPs on key private and public payer coverage and changes that impact the products access for patients
• Support patient access to the products by providing subject matter expertise on reimbursement issues that may be barriers to product access in a manner that complies with policies, processes, and standard operating procedures
• Educate HCPs and their practice personnel on the products Hub program including reimbursement, financial assistance and Hub tools (e.g. provider portal tool, copay tracking, forms)
• Demonstrate knowledge of and communicate information about resources and forms available for access and reimbursement
• Track and report on access and barriers to patient access within territory
• Liaise with Hub regarding reimbursement and financial assistance programs and assist HUB hotline staff in addressing case, coverage, or reimbursement resolutions
• Verification, pre-authorization, billing, coding, claims, and appeals/grievances); Medicare and Medicaid rules and regulations

Job Requirements

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

• BS/BA Degree required
• 5+ years in Commercial Biotech/Pharmaceutical experience
• 2+ years field reimbursement experience preferably with specialty products
• Proven experience with Hubs, in-depth knowledge on issues related to billing, coding, appeals across physician types
• Experience with commercial payers, Medicare plans and state Medicaid in geographic region
• Exhibit competent understanding of Hub activities

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)