Field Reimbursement Manager (FRM) - Southern California

Position Summary The Field Reimbursement Manager (FRM) serves as the subject‑matter expert on reimbursement, access, and coverage issues for our products, primarily focusing on Nephrology and Rare Disease. This role operates as a crucial liaison between healthcare providers (HCPs), internal teams, and external stakeholders to facilitate appropriate patient access to our products. Key Responsibilities Educate HCPs and their staff on matters related to access, coverage, reimbursement processes, claims submissions, and coding requirements Analyze payer criteria and provide product access expertise to healthcare offices Coordinate with Hubs on individual patient cases, including patient support services and enrollment Collaborate with Field Sales, Specialty Pharmacy Accounts, and other matrix partners Manage daily field‑based activities, spending 60-70% of time interacting with key stakeholders across various care sites Execute collaborative territory plans through partnerships with internal and external stakeholders Review and educate offices on payer policies, including prior authorization requirements Provide feedback to internal teams on local payer trends and access issues Assist in resolving patient‑specific coverage challenges when requested by healthcare providers Skills and Abilities Excellent verbal and written communication skills Strong interpersonal and consultative abilities Self‑directed with outstanding organizational skills Ability to build and maintain strong relationships with internal and external customers Proficient in delivering training and presentations Qualifications Required: Bachelor's degree 5+ years of pharmaceutical industry experience, with focus on payer policy and reimbursement 3+ years of experience in benefit verifications, prior‑authorization requirements, or equivalent experience in patient access, billing, and coding in rare disease Preferred: Strong knowledge of Centers for Medicare & Medicaid Services (CMS) policies and processes, especially Medicare Part D Experience in "Buy and Bill" reimbursement environment Nephrology experience strongly preferred Comprehensive understanding of US healthcare system payer billing practices Proficiency in MS Office suite Travel Requirements Ability to travel up to 60-70% domestically Valid driver's license required Competencies Accountability for Results - Stay focused on key strategic objectives, be accountable for high standards of performance, and take an active role in leading change. Strategic Thinking & Problem Solving - Make decisions considering the long‑term impact to customers, patients, employees, and the business. Patient & Customer Centricity - Maintain an ongoing focus on the needs of our customers and/or key stakeholders. Impactful Communication - Communicate with logic, clarity, and respect. Influence at all levels to achieve the best results for Otsuka. Respectful Collaboration - Seek and value others’ perspectives and strive for diverse partnerships to enhance work toward common goals. Empowered Development - Play an active role in professional development as a business imperative. Company Benefits Comprehensive medical coverage Dental coverage Vision coverage Prescription drug coverage Company provided basic life insurance Accidental death & dismemberment coverage Short‑term and long‑term disability insurance Tuition reimbursement Student loan assistance Generous 401(k) match Flexible time off Paid holidays Paid leave programs For more information about our benefits: Otsuka is an equal opportunity employer. All qualified applicants are encouraged to apply and will be given consideration for employment without regard to race, color, sex, gender identity or gender expression, sexual orientation, age, disability, religion, national origin, veteran status, marital status, or any other legally protected characteristic. If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation, if you are unable or limited in your ability to apply to this job opening as a result of your disability. You can request reasonable accommodations by contacting Accommodation Request (View email address on click.appcast.io) . #J-18808-Ljbffr