Field Reimbursement Manager

The Field Reimbursement Manager (FRM) is responsible for managing an assigned territory focused on supporting Reimbursement and Patient services by providing assistance with patient reimbursement challenges for a specific drug (including Benefit Investigation, Prior Authorization, Claims Assistance, and Appeals) and educating the office on Payer landscape and services available through both remote interaction and on-site training. Key Responsibilities Provide on-site and on-demand education (including Lunch and Learns or Dinner presentations) for the office staff in regard to Reimbursement challenges and support services that are available. On-site/virtual interactions will average 15 per week. These activities are recorded in FRM CRM daily with reporting to manager weekly. Educate on Benefit Investigation, Prior Authorization Process, Support Center Services, Medicare and Commercial coverage and patient communication streams. Monthly activity reporting captures educational topics at FRM level reportable to client based on client expectation. This trended data is also reported quarterly to client. Reimbursement Support on Case management, billing and coding updates, appropriate claims submission, Specialty Pharmacy, Medical Benefit Interpretation, understanding medical necessity, claims and appeal assistance, information related to co-pay assistance and patient assistance programs. FRM will collaborate with case manager on average of 4/month and ad hoc as needed for escalations. These interactions are tracked in FRM CRM and hub system. Responsible for setting up appointments and completing outbound calls to targeted offices. Assist in completing backlog casework. Additional day-to-day in-office work. Interface with physicians and manufacturer representatives to obtain and provide patient and provider specific information. All FRM interactions/activities are tracked in FRM CRM which are reportable to management and client. Monitor program performance for physicians and manufacturer representatives in accordance with expectations. Territory performance will be monitored via FRM CRM dashboard daily. Trending results will be identified through quarterly reporting. Additionally, clients have the option to survey customers on program performance. Research and compile provider / manufacturer representative specific information for reimbursement database. (Includes account profiles) FRM will create a facility database on each new provider in FRM CRM. All interactions/activities are built utilizing this database. Minimum Job Qualifications 4-year degree in related field or equivalent experience 4+ years of healthcare related reimbursement experience Business Experience Strong medical reimbursement experience with Buy & Bill and/or Specialty Pharmacy. Experience supporting oncology products preferred Experience in the healthcare industry including insurance verification, prior authorizations, and/or claim adjudication, physician’s office or clinics. Must have Medicare and commercial insurance coverage experience. Must be able to deliver and document benefit investigation outcomes and relay status reports on a regular basis. Proven presentation skills and experience Proven ability to effectively handle multiple priorities and excellent organizational skills Strong Computer literacy to include PowerPoint and Web Meeting experience Specialized Knowledge/Skills Previous field experience, a plus Previous experience with specialty pharmacy a plus Account management experience, a plus Excellent Interpersonal skills. Excellent written and oral communication skills Problem solving and decision-making skills Travel Requirements Bilingual candidate needed in Miami, FL. Must reside in territory. Must be able to travel 80% (4 days a week) via automobile or plane. Must have a valid driver's license with a clean driving record/MVR. Physical Requirements Possible long periods of sitting and/or keyboard work. General office demands. Compensation We are proud to offer a competitive compensation package at McKesson as part of our Total Rewards. This is determined by several factors, including performance, experience and skills, equity, regular job market evaluations, and geographical markets. In addition to base pay, other compensation, such as an annual bonus or long-term incentive opportunities may be offered. Our Base Pay Range for this position $76,300 - $127,100 Equal Opportunity McKesson provides equal employment opportunities to applicants and employees, without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, age, genetic information, or any other legally protected category. McKesson is committed to being an Equal Employment Opportunity Employer and offers opportunities to all job seekers including job seekers with disabilities. If you need a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to View email address on click.appcast.io or View email address on click.appcast.io. Resumes or CVs submitted to this email box will not be accepted. #J-18808-Ljbffr