Field Reimbursement Manager - Kidney (Central California - Los Angeles & San Bernardino)

General Summary Field-based role as the local subject matter expert to nephrology practices, providing non-promotional access and reimbursement education, supporting timely patient access through effective troubleshooting and territory-level payer expertise. Key Duties and Responsibilities Establish compliant connections with nephrology office personnel involved in prior authorizations and patient access to specialty medications. Partner with case management to address escalated access issues; ensure coordinated handoffs using CRM triggers and workflows. Educate offices on copay, PAP, Bridge programs, and other affordability pathways. Follow up on case status and ensure offices understand insurance documentation requirements. Maintain understanding of commercial and government insurance coverage requirements and payer trends. Conduct on-site/virtual in-services and training on payer policies/formulary updates, PA/medical exceptions, coding/billing (ICD-10, CPT), documentation, distribution pathways, hub services, enrollment, and reimbursement workflows. Manage a multistate region independently; prioritize accounts by patient need, payer dynamics, and KPSP demand. Develop territory engagement plans; adhere to strict non-promotional guidelines and comply with legal/compliance/privacy requirements. Maintain confidentiality of patient health information and follow all relevant laws/regulations/company policies. Apply program business rules and work instructions for a consistent, compliant experience. Knowledge and Skills Experience with specialty biologics/rare disease therapies/complex pharmacy benefit products. Account management with HCP/office staff; ability to navigate payer portals, CRM systems, and field access tools. Strong communication/training/relationship-building; analytical and data/reporting skills. Strategic business/account planning; sound judgment; travel 50–70%; Microsoft Office and Salesforce CRM. Valid driver’s license; ability to meet healthcare industry representative credentialing requirements. Education and Experience Bachelor’s degree in health care/life sciences/business (advanced degree a plus). 5+ years in sales, reimbursement, market access, specialty pharmacy, patient services, or field-based access roles. Deep understanding of benefits investigations, PA processes, appeals, coverage policies, and payer ecosystems; payer knowledge of Medicare/Medicaid/commercial. Pay Range (base salary) $136,000 - $204,000 Application/Contact Contact Talent Acquisition at View email address on click.appcast.io for application assistance. #J-18808-Ljbffr