Field Reimbursement Manager - Casper WY
Field Reimbursement Manager - Casper WY
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1 Vacancy
Job Description
At Amgen if you feel like youre part of something bigger its because you are. Our shared missionto serve patients living with serious illnessesdrives all that we do.
Since 1980 weve helped pioneer the world of biotech in our fight against the worlds toughest diseases. With our focus on four therapeutic areas Oncology Inflammation General Medicine and Rare Disease we reach millions of patients each year. As a member of the Amgen team youll help make a lasting impact on the lives of patients as we research manufacture and deliver innovative medicines to help people live longer fuller happier lives.
Our award-winning culture is collaborative innovative and science based. If you have a passion for challenges and the opportunities that lay within them youll thrive as part of the Amgen team. Join us and transform the lives of patients while transforming your career.
Tezspire Field Reimbursement Manager (FRM)
Live
What you will do
The Tezspire Field Reimbursement Manager (FRM) will manage defined accounts within a specified geographic region in the respiratory therapeutic area. This role involves supporting our products by executing the collaborative territory strategic plan. The FRM will ensure an understanding of the reimbursement process field reimbursement services and patient support programs. They will also work on patient-level reimbursement issue resolution requiring knowledge and experience with patient health information (PHI).
Key Responsibilities:
Act as an extension of the HUB providing live one-on-one coverage support
Offer assistance from physician order to reimbursement supporting the entire reimbursement journey through payer prior authorization to appeals/denials requirements and forms.
Review patient-specific information in cases where the site has specifically requested assistance resolving any issues or coverage challenges.
Educate and update healthcare providers (HCPs) on key private and public payer coverage and changes that impact patient product access.
Coordinate access/reimbursement issues with relevant partners including the HUB.
Provide information to HCPs on how the products are covered under the benefit design (Commercial Medicare Medicaid).
Serve as a payer expert for defined geography and promptly communicate payer changes to key stakeholders.
Offer office education during the access process including formulary coverage/utilization management criteria insurance forms & procedures benefits investigation prior authorization appeal and/or claims resolution.
Educate offices using approved materials.
Review patient insurance benefit options and alternate funding/financial assistance programs.
Collaborate with other departments to resolve reimbursement issues.
Additional Qualifications/Responsibilities
What we expect of you
We are all different yet we all use our unique contributions to serve patients
Minimum Job Qualifications:
Minimum two years of experience in public or private third-party access arena or pharmaceutical industry in managed care clinical support and/or sales
Strong medical reimbursement experience and/or Specialty Pharmacy and Buy & Bill knowledge
Proven presentation and facilitation skills
Strong written and oral communication skills
Organizational skills and project management experience including the ability to manage multiple projects
Strong computer literacy including Word Excel and PowerPoint and the ability to conduct web-based meetings
Experience in the healthcare industry including insurance verification claim adjudication physicians offices or clinics pharmacies and/or pharmaceutical manufacturers
Proven experience with hubs and in-depth knowledge of issues related to billing coding and appeals across physician types
Strong collaboration and ability to lead cross functional partner meetings
Experience with commercial payers Medicare plans and state Medicaid in a geographic region
Preferred Qualifications:
Bachelors degree in business healthcare or a related field
Experience with specialty/biologic self-injectable (pharmacy benefit) or physician-administered (buy and bill/medical benefit) products
Advanced knowledge of medical insurance terminology
Knowledge of Centers of Medicare & Medicaid Services (CMS) policies and processes with expertise in Medicare (Part B for buy & bill products and Part D for Pharmacy products)
Ability to manage ambiguity and problem-solve
Ability to manage expenses within allocated budgets
Working Conditions:
General office demands Remote Work from Home.
One to two home office days per week.
Must be able to travel up to 60-70% via automobile or plane.
Must have a valid drivers license with a clean driving record.
Possible long periods of sitting and/or keyboard work.
Required Experience:
Manager
Employment Type
Full Time
