Field Reimbursement Manager St. Louis, MO

Career Category

Job Description

Territory Covers: Springfield MO; Fort Smith AR; Cape Giradeau MO; Columbia MO; Little Rock AR; Jonesboro AR

Join Amgens Mission of Serving Patients

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.

Field Reimbursement Manager St. Louis MO

What you will do

Lets do this. Lets change the this vital role the Field Reimbursement Manager (FRM) will manage defined accounts within a specified geographic region for Patient Access and Reimbursement. This role involves supporting 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).

• 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

Working Conditions:

• 3 days a week in geography for customer appointments (geography specific)

• General office demands Remote Work from Home

• One to two home office days per week

• Must be able to travel up to 60-80% via automobile or plane

• Must have a valid drivers license with a clean driving record

• Possible long periods of sitting and/or keyboard work

What we expect of you

We are all different yet we all use our unique contributions to serve patients. The field reimbursement professional we seek is a collaborator with these qualifications.

Basic Qualifications:

• Doctorate degree OR

• Masters degree and 3 years of customer service and/or leadership experience OR

• Bachelors degree and 5 years of customer service and/or leadership experience OR

• Associates degree and 10 years of customer service and/or leadership experience OR

• High school diploma / GED and 12 years of customer service and/or leadership experience

• In addition to meeting at least one of the above requirements you must have experience directly managing people and/or leadership experience leading teams projects programs or directing the allocation of resources. Your managerial experience may run concurrently with the required technical experience referenced above

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

• Live in the geography or less than 10 miles from the geography border

Preferred Qualifications:

• Bachelors degree in business healthcare or a related field

• 6 years 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

• 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

What you can expect from us

As we work to develop treatments that take care of others we also work to care for your professional and personal growth and well-being. From our competitive benefits to our collaborative culture well support your journey every step of the way.

The expected annual salary range for this role in the U.S. (excluding Puerto Rico) is posted. Actual salary will vary based on several factors including but not limited to relevant skills experience and qualifications.

In addition to the base salary Amgen offers a Total Rewards Plan based on eligibility comprising of health and welfare plans for staff and eligible dependents financial plans with opportunities to save towards retirement or other goals work/life balance and career development opportunities that may include:

• A comprehensive employee benefits package including a Retirement and Savings Plan with generous company contributions group medical dental and vision coverage life and disability insurance and flexible spending accounts

• A discretionary annual bonus program or for field sales representatives a sales-based incentive plan

• Stock-based long-term incentives

• Award-winning time-off plans

• Flexible work models including remote and hybrid work arrangements where possible

Apply now and make a lasting impact with the Amgen team.

In any materials you submit you may redact or remove age-identifying information such as age date of birth or dates of school attendance or graduation. You will not be penalized for redacting or removing this information.

Application deadline

Amgen does not have an application deadline for this position; we will continue accepting applications until we receive a sufficient number or select a candidate for the position.

As an organization dedicated to improving the quality of life for people around the world Amgen fosters an inclusive environment of diverse ethical committed and highly accomplished people who respect each other and live the Amgen values to continue advancing science to serve patients. Together we compete in the fight against serious disease.

Amgen is an Equal Opportunity employer and will consider all qualified applicants for employment without regard to race color religion sex sexual orientation gender identity national origin protected veteran status disability status or any other basis protected by applicable law.

We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process to perform essential job functions and to receive other benefits and privileges of employment. Please contact us to request accommodation. Amgen is an Equal Opportunity employer and will consider you without regard to your race color religion sex sexual orientation gender identity national origin protected veteran status or disability status.

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