Associate Director, Field Reimbursement - iovera/Zilretta Northeast

Overview Associate Director, Field Reimbursement is a customer-facing role reporting to the Senior Director of Market Access & Reimbursement, responsible for managing defined accounts within a specified region in the Non-Opioid Pain Therapeutic area. This role supports a specialty buy-and-bill therapy by driving product reimbursement and coverage, removing access barriers, and partnering with internal and external stakeholders to execute strategic plans. The position represents Pacira and the value of its products, facilitates understanding of reimbursement services, builds relationships with key healthcare influencers, and serves as the internal expert on medical coding, billing, and reimbursement. Responsibilities Act as an extension of EXPAREL, providing live one-on-one coverage support. Offer assistance from physician order to reimbursement, supporting the entire reimbursement journey through payer prior authorization to appeals/denials requirements, procedures and forms. Review patient-specific information to resolve coverage challenges as requested by sites. Review patient insurance benefit options. Coordinate with Pacira’s patient support services program representatives. Educate physician office staff on Pacira’s call center support services and web-based provider programs. Provide information on relevant reimbursement topics related to Pacira’s portfolio. Serve as payer expert for defined geography and communicate changes to key stakeholders in a timely manner. Provide office support in accurate coding and billing for Pacira’s portfolio. Qualifications Education and Experience: Bachelor’s degree from an accredited college or university in Health Policy, Finance, Business, or related fields. Minimum of 6+ years related experience in the healthcare industry. Minimum of 3 years of relevant reimbursement experience, particularly managing targeted reimbursement relationships. Knowledge, Skills, and Abilities: General payer policy knowledge including managed care and Medicare/Medicaid. Foundational knowledge of benefit verifications and prior authorization requirements. Knowledge of reimbursement and billing processes within the physician office. Ability to review clinical information in patient charts and interpret payer policy to guide HCP offices on prior authorization, formulary exceptions, and appeals. Specific knowledge of specialty product buy-and-bill, coding, and in-office program management. Proven track record in managing medical billing, coding, appeals, denials, and single-case rates. Excellent written and verbal English communication and presentation skills. Ability to partner across the organization without a direct reporting line and think strategically with limited structure. Strong problem-solving, analytic, and negotiation skills with high-value contracts and partnerships. Extensive reimbursement experience with understanding of CMS and Commercial payment models/trends. Valid driver’s license in the residing state. Physical Demands Regularly required to sit, talk, move between spaces, reach with hands and arms, and stoop. Close vision for computer use; ability to travel at least 50% of the time. Work Environment Work from home or remote locations such as airports, hotels, and off-site meetings. Moderate noise level typical of a remote work setting. Benefits Medical, Prescription, Dental, Vision Coverage Flexible Spending Account & Health Savings Account with Company match Employee Assistance Program Mental Health Resources Disability Coverage Life Insurance Critical Illness and Accident Insurance Legal and Identity Theft Protection Pet Insurance Fertility and Maternity Assistance 401(k) with company match Flexible Time Off (FTO) and 11 paid holidays Paid Parental Leave Pay Transparency The base pay range for this role is $141,000 per year to $175,000 per year. The range reflects compensation decisions based on factors including geographic market, business needs, skills, experience, training, licensure, and certifications. EEO Statement Pacira is an Equal Opportunity Employer and does not discriminate based on race, color, religion, sex (including gender identity, sexual orientation, and pregnancy), national origin, age, veteran status, disability or genetic information. We are committed to inclusion and a culture of trust and transparency. Agency Disclaimer: Pacira Biosciences, Inc. does not accept unsolicited resumes from recruiters or employment agencies. Pacira reserves the right to hire without any obligation to the recruiter or agency. #J-18808-Ljbffr