Reimbursement Manager

Field Reimbursement Manager (Rare Neurology, Hematology, & Nephrology)This is what you will do: The Field Reimbursement Manager (Rare Neurology, Hematology, & Nephrology) is a field-based, non-promotional role responsible for helping minimize barriers to patient access for our rare disease portfolio. You will act as the local subject matter expert on reimbursement, billing, coding, and patient support programs for assigned indications and therapies. By educating healthcare provider (HCP) offices, billing staff, and financial coordinators, you will help navigate complex coverage landscapes to ensure eligible patients receive timely access to therapy. This role reports directly to the Regional Field Reimbursement Director.You will be responsible for:Partnering with Alexion cross-functional partners on overall account and territory planning and strategy to maximize internal/external customer knowledge on payer policy and processes as well as routine documentation and presentation of plans.Being a subject matter expert on reimbursement and regional-specific access landscape. This includes medical/pharmacy benefit design, product acquisition, payer policies and coverage criteria, prior authorization requirements, denials, appeals, peer to peer and other education required to navigate access for coverage of assigned Alexion indications and therapies while operating in full alignment with company policy, legal requirements, and compliance standards.Developing and executing strategic account and territory plans that increase customer knowledge of reimbursement and access processes, using available resources, internal data, and field insights to prioritize activity and guide call objectives.Collaborating with Alexion OneSource Patient Services on individual case management needs related to HCP education on reimbursement issues.Identifying, documenting, and communicating field insights related to payer policy shifts, access barriers, denial trends, operational challenges, and customer education needs to help inform internal planning and decision-making.Collaborating with cross-functional partners to share insights and coordinate/plan activities; attending internal regularly (with market access, patient services, medical, sales, compliance, legal, and other relevant partners, as appropriate) and company meetings as requested.Maintaining accurate documentation and operational reporting related to customer interactions, account plans, HCP office education, and case-related activity in CRM and other approved systems, while managing work in alignment with annual priorities, key performance indicators, territory objectives, project priorities, and approved budget parameters.Complying with all laws, regulations, and policies that govern the conduct of Alexion activities; works with the highest degree of professionalism and in accordance with the company's code of Ethics and Business Conduct.You will need to have:Bachelor's degree5-7 years experience in the healthcare and/or pharmaceutical/biotech industry3+ years experience working with buy and bill and/or specialty pharmacy networks3+ years of field reimbursement experienceUnderstanding of access process from medical and pharmacy benefit design, Rx to infusion/injectionExperience with products that require prior authorization and clear understanding of related billing, coding and in-office supportDemonstrate adaptability to changing direction as conditions shift, learning mindset, taking ownership and driving actionsExcellent verbal, written, interpersonal communication and presentation skillsAbility to effectively communicate with people at all levels, inside and outside of the companyAbility to educate physicians and other healthcare professionals with confidence and expertise in an office procedural environmentDemonstrated strong cross-functional collaboration skills, business planning, rapport building and active listening skillsProblem solver with a sense of urgencyExperience working through complex reimbursement issuesExperience working with billing and medical claim personnel in healthcare settingExperience working with integrated health systemsDemonstrated technical aptitude and working proficiency in using iPad and Laptop and working proficiency in Microsoft Word, Excel, PowerPoint, and Outlook; willingness to travel with equipment to coordinate daily with key partners on education and case work.The duties of this role are generally conducted in a field environment. As is typical of a field-based role, employees must be able, with or without an accommodation to: travel by public transportation, automobile, train, or plane; work comfortably in a clinical setting; use a computer; engage in communications via phone, video, and electronic messaging; problem solve; engage in complex and non-linear thought, analysis, and dialogue; collaborate with others; maintain general availability during standard business hours; operational reporting while traveling.Travel and Role Related Areas:Ability to travel to work related meetings and functions and ability to travel overnight for up to 4 nights per weekAbility to travel 60-75%Ability to drive to assigned targets within the territory with Company provided Fleet Electric VehicleA valid driver's license and clean driving recordAbility to travel regionally and cover large multi-state territoriesMust reside in the assigned territory; relocation assistance is not providedWe would prefer for you to have:Rare disease experienceUnderstanding of the top regional and national payers within the assigned geographyExperience in launching a new specialty pharmaceutical/biologic product or new product indicationNeurology, Hematology and/or Nephrology experienceExperience working through complex reimbursement issuesExperience working with billing and medical claim personnel in healthcare settingPACS (Prior Authorization Certification Specialist)Familiarity with applying AI tools and techniques to enhance efficiencyReside within TexasOur mission is to build an inclusive environment where equal employment opportunities are available to all applicants and employees. In furtherance of that mission, we welcome and consider applications from all qualified candidates, regardless of their protected characteristics. If you have a disability or special need that requires accommodation, please complete the corresponding section in the application form.