Field Reimbursement Manager

Field Reimbursement Manager (FRM)
Key Responsibilities

• Act as a compliant subject matter expert (SME) in reimbursement, access, and specialty distribution for assigned geography.
• Educate HCP offices on coverage status, prior authorization processes, appeals, and alternate funding options for uninsured/underinsured patients.
• Build and maintain relationships with HCPs, office staff, and health system stakeholders.
• Analyze regional/local payer coverage trends, reimbursement criteria, and payer mix.
• Provide guidance on specialty pharmacy services and help navigate complex distribution channels.
• Partner with the Patient Support team for accurate benefit investigations and streamlined patient onboarding.
• Collaborate with internal partners to build local access strategies aligned with business objectives.
• Develop and execute territory-level business plans using strategic customer insights.
• Resolve reimbursement issues in the field; escalates cases when needed.
• Identify process improvements to enhance patient access and provider satisfaction.
• Maintain compliance with applicable legal/regulatory requirements and policies (including patient privacy and promotional conduct).

• Bachelor’s degree in an allied health field preferred or equivalent work experience.
• 8+ years in pharmaceutical/biotech/related healthcare industry.
• Substantial reimbursement experience required, including prior authorizations and navigating the US payer landscape.
• 3–6 years supporting specialty pharmaceuticals/biologics.
• Deep understanding of reimbursement, access, and specialty pharmacy operations.
• Experience supporting product launches or patient navigation through insurance approval.
• Strong knowledge of specialty pharmacy distribution models and patient services programs.
• Knowledge of HIPAA and federal/state laws governing patient confidentiality and healthcare communications.
• Bilingual (English/Spanish) highly desired.
• Proven track record supporting complex therapies in rare or specialty conditions.
• Exceptional communication/interpersonal skills; ability to build trust with providers and internal partners.
• Ability to manage ambiguity and multiple cases simultaneously; real-time problem solving.
• Digital fluency with CRM platforms; comfort educating using technology-enabled tools, including AI-based platforms.

• 401(k) plan with company match; comprehensive medical/dental/vision.
• Company-paid Life and AD&D; company-paid short/long-term disability.
• Voluntary Pet Insurance and Legal Insurance; EAP.
• Employee Discounts and Professional Development programs.
• HSA and FSA.
• Accident, Critical Illness, and Hospital Indemnity Insurance.
• Paid parental leave and mental health resources.
• Performance-based incentive compensation plans.