Field Reimbursement Manager Hemophilia Position Available In Middlesex, New Jersey

Job Description:

Payrate:

$64.86 – $64.86 / hr.

Job Summary:

We are seekingexperienced and passionate Field Reimbursement Managers to join ourteam, specializing in hemophilia. This role will focus on ensuringaccess to our hemophilia therapies, educating healthcareprofessionals about reimbursement processes, and collaborating withinternal teams to support our commitment to improving patientoutcomes.

Key Responsibilities:

Serve as a primary point of contactfor healthcare providers and internal stakeholders regardingreimbursement-related inquiries for hemophilia therapies.

Collaborate with provider offices and specialty pharmacies, andprovider offices to facilitate reimbursement and establishproductive working relationships. Monitor reimbursement trends andchanges in healthcare policies that may impact access to hemophiliatreatments, advising the organization as needed. Assist inbuilding, tracking, and reporting on key performance indicators tomonitor overall performance. Work closely with Care to reviewbenefits investigation and provide prior authorization and appealssupport, as requested. Ensure compliance with reimbursementregulations and guidelines. Develop and maintain relationships withbilling and coding staff, and develop a deep understanding of theirbusiness including patient demographics, payer landscape, regionalpayers, networks/affiliations, etc. Use approved tools, such asdashboards and coding guides to assist offices with a smooth andefficient patient journey towards therapy access. Gather andanalyze data on reimbursement challenges and address themproactively through collaboration with cross-functional teams.

Manage their own budget. Successfully manage other projects asdirected with proven results. Access Education Educate healthcareprofessionals and patient support teams about existingreimbursement processes, policies, and available financialassistance programs. Assist HCPs in understanding patients’insurance benefits, navigating financial assistance options, andovercoming access barriers. Provide training and resources tointernal sales and marketing teams about reimbursement processesrelated to hemophilia therapies. Deliver approved leave-behindproduct educational materials to help inform relevant officepersonnel of reimbursement landscape/policies/criteria. Communicateand Collaborate Collaborate with other field reimbursement managersto identify the best practices seen in different practice settingsacross the country. Quickly identify, communicate, and addressoutstanding reimbursement issues and trends, escalating to FRMleadership, Sales, Market Access, Marketing and others to helpinform additional support and resource needs. Proactivelycommunicate with the Market Access account team to gain a completeunderstanding of payer-specific coverage, medical and pharmacypolicies, and utilization management criteria (i.e. Step Therapy,PA, etc.). Regularly interact with field matrix teams to identify,assess and address issues in assigned geography. Inform and supportinternal teams on the development of reimbursement relatedresources and tools for use by customers.

Required Qualifications:

Bachelor’s degree required, preferably in a science or businessdiscipline. 4 years of relevant pharmaceutical sales orreimbursement experience with at least 2 years field reimbursement(pharmacy and buy-n-bill) experience. Comprehensive knowledge andunderstanding of payer billing practices in the US health caresystem, including Medicare, Commercial, Medicaid and other payerarchetypes. Strong understanding of drug reimbursement processesand insurance policies. Experience in the manufacturing sector,particularly in understanding the supply chain and distributionprocesses for pharmaceutical products. Preferred experience inimplementing patient access initiatives (i.e. hub programs).Preferred knowledge of hemophilia treatment landscape and relatedregulatory guidelines. Skills Necessary for

Success:

Excellentcommunication and interpersonal skills to build relationships withhealthcare providers and internal teams. Technical knowledge ofhealth care reimbursement from a patient and provider perspective(authorizations, miscellaneous J codes, billing, coding, priorauthorizations, appeals, patient and provider support programs andHUB operations). Strong analytical and problem-solving skills toproactively identify and resolve reimbursement issues. Firmunderstanding of HIPAA rules and regulations related to patientprivacy. Ability to work independently and collaboratively within afast-paced team environment. Proficient in utilizing reimbursementsoftware tools and CRM systems to track interactions and outcomes.

High level of empathy and commitment to patient advocacy.

PayTransparency:

The typical base pay for this role across the U.S.

is:

$ 64.86 – $64.86 / hr. Final offer amounts, within the base payset forth above, are determined by factors including your relevantskills, education and experience and the benefits package youselect. Fulltime employees are eligible to select from differentbenefits packages. Packages may include medical, dental, and visionbenefits, 10 paid days off, 401(k) plan participation, commuterbenefits and life and disability insurance. For information aboutour collection, use, and disclosure of applicant’s personalinformation as well as applicants’ rights over their personalinformation, please see our Privacy Policy(https://www.aditiconsulting.com/privacypolicy). Aditi ConsultingLLC uses AI technology to engage candidates during the sourcingprocess. AI technology is used to gather data only and does notreplace human based decision making in employment decisions. Byapplying to this position, you agree to Aditi’s use of AItechnology including calls from an AI Voice Recruiter.