Field Reimbursement Manager - Kidney (Southern California - San Diego and Anaheim)

Key Duties and Responsibilities Build compliant connections with nephrology practice staff (care team and prior authorization/patient access administrators) to support access to prescribed specialty medications. Partner with case management to resolve escalated access issues and coordinate handoffs via CRM workflows. Educate offices on copay, PAP, Bridge programs, and other affordability pathways; follow up on case status and documentation needs. Maintain knowledge of commercial and government insurance coverage requirements and payer trends. Deliver compliant on-site/virtual in-services and training on payer policies, formularies, PA/medical exception criteria, ICD-10/CPT coding, documentation, distribution pathways, hub services, enrollment, and reimbursement workflows. Independently manage a multistate territory; prioritize accounts based on patient need, payer dynamics, and KPSP demand. Develop territory engagement plans to minimize patient-specific access barriers; adhere to strict non-promotional and confidentiality requirements. Knowledge and Skills Specialty biologics/rare disease/complex pharmacy benefit experience; account management with HCPs/office staff. Ability to navigate payer portals and CRM/field access tools; strong training/relationship-building, analytical, and data/reporting skills. Comfort in fast-paced, results-driven environment; experience creating strategic account plans; sound judgment. Travel 50–70% within territory; MS Outlook/Word/Excel/PowerPoint; Salesforce CRM. Valid driver’s license; meet healthcare industry credentialing requirements. Education and Experience Bachelor’s degree (health care, life sciences, or business); advanced degree preferred. 5+ years in sales, reimbursement, market access, specialty pharmacy, patient services, or field-based access. Deep understanding of benefits investigations, PA/appeals, coverage policies, and Medicare/Medicaid/commercial. Compensation/Benefits Pay range: $136,000–$204,000. Eligible for annual bonus and annual equity awards; may be eligible for overtime (as applicable). #J-18808-Ljbffr