Field Reimbursement Manager - West

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The EVERSANA/Theratechnologies Field Reimbursement Manager (FRM) plays a critical role in minimizing access and reimbursement barriers for patients and healthcare providers to ensure timely access to the product portfolio. By addressing complex patient access challenges, the FRM serves as a trusted resource for private practices, multi-specialty groups, and facilities, supporting them throughout the reimbursement cycle. This role collaborates closely with Market Access, Patient Services, and Field Sales teams to ensure seamless patient drug accessibility and delivers compliant, patient-focused solutions to optimize access.

• Proactively address patient access barriers by working with customers and accounts to resolve complex reimbursement issues, including prior authorizations, appeals, and denials.
• Educate private practices, multi-specialty groups, facilities, and their staff on reimbursement support programs, coverage, coding, and payer policies.
• Partner with internal and external stakeholders to identify, anticipate, and address patient and practice reimbursement challenges.
• Collaborate cross-functionally with Market Access, Patient Services, and Field Sales to provide compliant support for patients’ access to therapy.
• Deliver clear and actionable information to practice managers, billing staff, nurses, and reimbursement teams to improve their understanding of payer policies and processes.
• Provide real-time communication on payer policy updates and system changes that impact patient access in assigned accounts.
• Conduct regular reviews with practices to understand their utilization of reimbursement support services and recommend program enhancements based on customer needs.
• Handle patient health information (PHI) in accordance with HIPAA guidelines and company compliance policies.
• Demonstrate a commitment to diversity, equity, and inclusion through continuous development, modeling inclusive behaviors, and proactively managing bias.
• Maintain a deep understanding of policies, industry trends, and the legal and compliance aspects of reimbursement, applying this knowledge to all responsibilities.
• Ensure a compliant relationship with state, local, and institutional societies while educating and supporting practices and accounts.
• Share insights into customer needs, potential access barriers, and payer trends with internal teams to drive actionable improvements.
• All other duties as assigned

• Education:
  
  Bachelor’s Degree
• Experience and/or Training:
• Proven experience in resolving complex patient access challenges, including prior authorizations, appeals, and denials.
• Strong knowledge of the US healthcare system, reimbursement policies, and patient assistance programs.
• Familiarity with the appropriate handling and use of PHI…