Field Reimbursement Manager- CENTRAL CALIFORNIA *URGENT NEED*

Job Description Field Reimbursement Manager (FRM) in Central California/Various Travel Locations (including Los Angeles & Beverly Hills). Responsible for managing an assigned territory focused on supporting Reimbursement and Patient services by providing assistance with patient reimbursement challenges for a specific drug (including Benefit Investigation, Prior Authorization, Claims Assistance, and Appeals) and educating the office on Payer landscape and services available through both remote interaction and on-site training. Position is client-facing and requires the ability to build relationships with physician offices as well as manufacturer representatives to effectively deliver services. Works independently in a fast paced, highly visible environment and collaborates with internal program hub support services to ensure all customer needs are met. Frequently interacts via telephone with providers and internal staff to arrange site visits, manufacturer trainings, and educational venues. Must have solid working knowledge of Medicare and Commercial insurance plans and benefit structures to relay detailed benefit information and maximize the customer experience. Requires travel, project management and/or account coordination based on client expectation. Key Responsibilities Provide on-site and on-demand education (including Lunch and Learns) for office staff on reimbursement challenges and support services; record and track activities for reporting purposes. Educate on Benefit Investigation, Prior Authorization Process, Support Center Services, Medicare and Commercial coverage and patient communication streams; report monthly and quarterly. Offer reimbursement support on case management, billing and coding updates, claims submission, specialty pharmacy, medical benefit interpretation, Medicaid, co-pay assistance and patient assistance programs; collaborate with stakeholders to ensure timely workflow. Set up appointments, complete outbound calls, assist with backlog casework; interface with physicians and manufacturer representatives; track all interactions in FRM CRM. Monitor program performance for physicians and manufacturer representatives; use FRM CRM dashboard to identify trends and support quarterly reporting. The best FRM candidates will Bring 3 years FRM territory experience (including experience working without access to PHI). Truly care about patients and work through all roadblocks to get medications approved. Have expertise in retail pharmacy and specialty drug prior authorizations through portals, benefit investigations, appeals. Have local payor landscape knowledge: Medicare & Medicaid. Know workarounds when PHI is not accessible. Have 2-4 years experience in escalations, education, commercial co-pay card approvals, patient assistance program approvals, foundation coverage, guidelines, and reimbursement; stay up-to-date on drug programs, FDA indications, J-codes, and payer policy changes. Business Experience Entry-level experience in project management. Minimum of 5 years healthcare-related reimbursement experience; strong medical reimbursement experience with buy & bill and/or specialty pharmacy. Experience supporting program-specific drug therapy space (e.g., oncology, dermatology). Experience in the healthcare industry including (but not limited to) insurance verification, prior authorizations, claim adjudication, physician’s office or clinics. Must have Medicare and commercial insurance coverage experience. Must be able to deliver and document benefit investigation outcomes and relay status reports regularly. Strong customer service experience. Proven presentation skills and experience. Ability to effectively handle multiple priorities within a changing environment. Excellent organizational skills. Strong computer literacy (PowerPoint, web meeting). Specialized Knowledge/Skills Previous field experience (a plus). Previous experience with specialty pharmacy (a plus). Account management experience (a plus). Excellent interpersonal skills. Excellent written and oral communication skills. Problem solving and decision-making skills. Travel Requirements Must reside in territory. Must be able to travel 80% (4 days a week) via automobile or plane. Must have a valid driver’s license with a clean driving record/MVR. Equal Opportunity Statement We are an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, and other legally protected characteristics. #J-18808-Ljbffr 6AM City, LLC