Field Reimbursement Manager Position Available In Kennebec, Maine

Field Reimbursement Manager at Otsuka America Pharmaceutical Inc. in Augusta, Maine, United States Job Description Position Summary The Field Reimbursement Manager (FRM) serves as the subject-matter expert on reimbursement, access, and coverage issues for our products, primarily focusing on Nephrology and potentially other therapeutic areas. This role operates as a crucial liaison between healthcare providers (HCPs), internal teams, and external stakeholders to facilitate appropriate patient access to our products. Key Responsibilities + Educate HCPs and their staff on matters related to access, coverage, reimbursement processes, claims submissions, and coding requirements + Analyze payer criteria and provide product access expertise to healthcare offices + Coordinate with Hubs on individual patient cases, including patient support services and enrollment + Collaborate with Field Sales, Specialty Pharmacy Accounts, and other matrix partners + Manage daily field-based activities, spending 60-70% of time interacting with key stakeholders across various care sites + Execute collaborative territory plans through partnerships with internal and external stakeholders + Review and educate offices on payer policies, including prior authorization requirements + Provide feedback to internal teams on local payer trends and access issues + Assist in resolving patient-specific coverage challenges when requested by healthcare providers Qualifications + Bachelor’s degree required + Minimum 5 years of pharmaceutical industry experience, with focus on payer policy and reimbursement + At least 3 years of experience in benefit verifications, prior-authorization requirements, or equivalent experience in patient access, billing, and coding in rare disease + Strong knowledge of Centers for Medicare & Medicaid Services (CMS) policies and processes, especially Medicare Part D + Experience in “Buy and Bill” reimbursement environment + Nephrology experience strongly preferred + Comprehensive understanding of US healthcare system payer billing practices + Proficiency in MS Office suite Skills and Abilities + Excellent verbal and written communication skills + Strong interpersonal and consultative abilities + Self-directed with outstanding organizational skills + Ability to build and maintain strong relationships with internal and external customers + Proficient in delivering training and presentations Travel Requirements + Ability to travel up to 60-70% domestically + Valid driver’s license required Competencies •Accountability for Results –