Field Reimbursement Manager

Job Description

Field Reimbursement Manager – Tennessee, Alabama, Mississippi

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Nashville, TN (Field-Based)

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About the Company

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Our client is a commercial-stage biopharmaceutical company focused on developing and commercializing innovative therapies for diseases and conditions of the eye. With a strong product pipeline designed to reduce the complexity and burden of the current standard of care, the company is positioned to become a leader in ophthalmology. It values creative thinking, cross-functional collaboration, and a culture where employees can grow and achieve their career goals.

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Territory: TN, AL, MS

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Position Summary

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The Field Reimbursement Manager (FRM) is a regionally aligned, field-based role that provides access and reimbursement education and support for customers using the company's commercial product. Customers include healthcare providers (HCPs) and staff in physician offices, ambulatory surgery centers (ASCs), hospital outpatient departments (HOPDs), and other site-of-care facilities. The FRM works closely with HCPs, billing and coding staff, revenue cycle managers, and other professionals involved in securing appropriate access and reimbursement.

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The FRM provides product-specific reimbursement support, coordinates HUB reimbursement services, and manages payer and coverage pull-through initiatives. The role requires solid working knowledge of buy-and-bill products under Medical (Part B) reimbursement and a clear understanding of public and private insurance plans and benefit design.

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The FRM is expected to be a subject matter expert on access and reimbursement processes for a product with a permanent J-code paid under the medical benefit, including benefit verification, claims assistance, and appeals. The role also involves building strong relationships with provider practices and facilities, with a high degree of communication, account coordination, and cross-functional collaboration.

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Key Responsibilities

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• Proactively educate purchasers (clinics, ASCs, HOPDs), prescribers, and office staff so they can help patients access the product. This includes coding, J-code pull-through, and payer-specific billing and reimbursement guidance for government and private payers, using approved materials.
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• Address access and reimbursement issues as they arise and provide the education customers need to secure appropriate reimbursement.
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• Provide approved information on product coverage, including payer-specific claims requirements, prior authorizations, the appeals process, and general disease state information.
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• Work with HCPs to understand and resolve access and reimbursement issues, keeping cross-functional partners informed through resolution.
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• Partner regularly with National Account Directors and Key Account Managers to share field intelligence, payer policy, and market dynamics.
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• Coordinate with field sales on account prioritization and ongoing follow-up plans.
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• Serve as a primary point of contact for the Market Access team on corporate accounts, distribution, HUB, and payer issues.
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• Act as HUB liaison, educating customers on patient support programs, financial assistance, and funding options, and helping practices enroll patients in appropriate programs.
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Internal and External Contacts

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The FRM works with many stakeholders in a matrix environment to meet established goals.

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• Internal: Field Sales, Corporate Accounts, Payer Team, Marketing, Trade and Distribution, HUB management, outsourced HUB services, and Medical (as needed).
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• External: HCPs, clinics, HOPDs, ASCs, pharmacies, and billing and coding staff at key customers.
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Qualifications

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• BA/BS degree required.
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• 5–7 years of reimbursement and access experience preferred.
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• 3+ years of other pharma/biotech experience strongly preferred (e.g., Market Access, Sales, Product Marketing).
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• Experience launching specialty therapeutics in a buy-and-bill environment.
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• Comprehensive understanding of medical benefit policies across payer types (Medicare, Medicaid, commercial, VA/DoD) and sites of care (HOPDs, ASCs, clinics).
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• Ability to lead without authority in cross-functional teams and a matrix organization.
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• Exceptional communication, interpersonal, and problem-solving skills, with the ability to engage senior decision makers such as CFOs and revenue cycle leaders.
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• Demonstrated ability to identify access barriers and design effective resolution plans.
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• Commitment to compliance with corporate and industry policies, in collaboration with Legal, Regulatory, and Compliance.
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• Desire to innovate in a fast-paced, energetic environment.
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• Must live near a major airport and be able to travel approximately 70–75% (about 4 days per week).
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Salary Range: $200,000 – $220,000 USD

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Our client is an Equal Opportunity Employer and does not discriminate on the basis of race, color, religion, gender, sexual orientation, national origin, age, disability, veteran status, or any other protected characteristic.