Field Reimbursement Manager

Role Description

Field Reimbursement Manager (FRM) is a customer facing role that will be responsible to appropriately support the reimbursement process for providers and patients within a specific geographic region after receipt of a Harmony product prescription by our HUB. This role will be highly visible within the organization and responsible for providing education to healthcare providers and office staff on access services and reimbursement solutions.

• The FRM will execute a regional strategic plan through partnership with internal and external stakeholders, which may include call center services (HUB), market access, and/or field partners.
• After the prescription is submitted, provide relevant office education and awareness to HCP Office which may include formulary coverage/utilization management criteria, insurance forms & procedures, Codes, benefits investigation, prior authorization, appeal, and/or claims resolution.
• Educate offices on the requirements to obtain insurance authorization and/or reimbursement of products for appropriate patients in a compliant manner.
• Educate physician office staff on the use of Harmony’s patient support services, using approved educational materials.
• Manage daily activities that support appropriate patient access to Harmony’s products by the provider offices and act as an extension of the HUB, as appropriate and provide in-person customer visits.
• Conduct all activities in a compliant manner and will work closely within a defined set of Rules of Engagement, and other company guidance documents.
• Participate in meetings as appropriate.
• Input call activity into CRM, as appropriate.
• Review specific patient case information, in a compliant manner.
• Perform other duties as assigned.

Qualifications

• Bachelor’s Degree in a Business or related discipline required; Master’s Degree or higher preferred.
• 5+ years pharmaceutical / biotech reimbursement or access experience in limited distribution models or relevant experience; Experience launching rare disease product(s) or complex specialty products preferred.
• Demonstrated success of cross functional teamwork and working in a matrix environment.
• Experience in the reimbursement process, field reimbursement service, and patient support programs.
• Experience in coordinating patient and provider support services such as specialty pharmacy, HUB, and reimbursement services.
• Experience handling patient health information (PHI) in accordance with company policies and procedures.
• Candidates must live in assigned coverage area; Preference will be given to candidates residing in or near Seattle, WA; San Francisco, CA, San Jose, CA; however, candidates living anywhere within the region will be considered.

Requirements

• Travel is estimated to be 50% of the time for this position within assigned region.
• Must have a valid US driver’s license with the ability to safely operate a motor vehicle.
• While performing the duties of this job, the noise level in the work environment is usually quiet.
• The employee must occasionally lift and/or move more than 20 pounds.
• Specific vision abilities required by this job include close vision.
• Manual dexterity required to use computers, tablets, and cell phone.
• Continuous sitting for prolonged periods.

Benefits

• Medical, Vision and Dental benefits the first of the month following start date.
• Generous paid time off and Company designated Holidays.
• Company paid Disability benefits and Life Insurance coverage.
• 401(k) Retirement Savings Plan.
• Paid Parental leave.
• Employee Stock Purchase Plan (ESPP).
• Company sponsored wellness programs.
• Professional development initiatives and continuous learning opportunities.
• A certified Great Place to Work® for eight consecutive years based on our positive, values-based company culture.