Fresenius Kabi USA
Senior Field Reimbursement Manager - South Central
Fresenius Kabi USA, Oklahoma City, Oklahoma, United States, 73116
Senior Field Reimbursement Manager - South Central
Join to apply for the
Senior Field Reimbursement Manager - South Central
role at
Fresenius Kabi USA .
This role reports to the Senior Field Reimbursement Manager and is based in or near one of the designated cities with the ability to travel within the territory.
Overview The Senior Field Reimbursement Manager (FRM) plays a vital role in helping patients gain access to life-changing therapies. FRMs educate and assist provider offices on prior authorization requirements, coverage status, and payer appeals, and help resolve complex coverage and reimbursement issues to decrease access barriers for patients. The FRM travels weekly, Monday – Thursday, to healthcare offices within a designated geographic territory and uses knowledge of coverage, patient assistance, and health policy to educate office staff and improve access to therapies.
Responsibilities
Develop solutions and action plans to reimbursement issues or opportunities, condensing complex issues into clear actions with internal stakeholders to improve the customer experience.
Educate provider offices on local and regional payer issues, coding changes, and appropriate claims submission processes.
Liaise with reimbursement hotlines regarding alternative funding or financial assistance programs.
Assist with determining coverage and access options for a specific medication or procedure.
Engage with Medicare Advisory Carriers, MACs, and Monitor Local Coverage Determinations to ensure coverage aligns with product labeling.
Collaborate with internal partners to build strategic patient access and reimbursement account plans; stay informed on customer and industry trends and adapt capabilities to increase impact.
Support achievement of customer and product strategies by working with a broad stakeholder team.
Provide customer insights and product trends to HQ to shape current and future strategies.
Analyze and measure key business drivers and objectives, including relationship effectiveness and value proposition for assigned customers.
Communicate with national commercial payers, PBMs, Medicaid, Medicare, clinical pathway organizations, payer-owned specialty pharmacies, product distribution updates, and state government affairs.
Ensure compliance with Health, Safety, Environment, Energy and Quality Management System requirements relevant to the role.
Requirements
Bachelor’s degree required; advanced degree preferred.
7+ years’ experience with specialty providers in reimbursement; experience with both private and public payers strongly preferred.
Technical knowledge of health care reimbursement from patient and provider perspectives (authorizations, J codes, billing, coding, prior authorizations, appeals, patient and provider support programs and HUB operations).
Knowledge of all phases of specialty pharmacy core services and connectivity to patient access complexity.
Knowledge of private payer, Medicare and Medicaid structures and reimbursement processes.
Strong business and clinical acumen with leadership abilities and the ability to lead without authority.
Excellent written and oral communication, with strong presentation skills for key stakeholders and decision-makers.
Strategic thinker with the ability to create action plans and resolve issues.
Ability to work with senior leaders across functional groups to build consensus and drive action.
Demonstrated success in account management and the ability to work independently.
Willingness to travel extensively (overnight, ~80% of the time) within the designated territory; must live near a major airport in the territory.
Additional Information Salary Range: $155,000 – $165,000 per year
Position is eligible to participate in a bonus plan with a target of 14% of base salary. Final pay determinations depend on experience, education, knowledge, skills, and abilities. Benefits include medical, dental, and vision coverage, life insurance, disability, 401(k) with company contribution, and wellness programs.
Fresenius Kabi is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, citizenship, immigration status, disabilities, or protected veteran status.
Employment type
Full-time
Job function
General Business
Industries
Pharmaceutical Manufacturing
Hospitals and Health Care
#J-18808-Ljbffr
Senior Field Reimbursement Manager - South Central
role at
Fresenius Kabi USA .
This role reports to the Senior Field Reimbursement Manager and is based in or near one of the designated cities with the ability to travel within the territory.
Overview The Senior Field Reimbursement Manager (FRM) plays a vital role in helping patients gain access to life-changing therapies. FRMs educate and assist provider offices on prior authorization requirements, coverage status, and payer appeals, and help resolve complex coverage and reimbursement issues to decrease access barriers for patients. The FRM travels weekly, Monday – Thursday, to healthcare offices within a designated geographic territory and uses knowledge of coverage, patient assistance, and health policy to educate office staff and improve access to therapies.
Responsibilities
Develop solutions and action plans to reimbursement issues or opportunities, condensing complex issues into clear actions with internal stakeholders to improve the customer experience.
Educate provider offices on local and regional payer issues, coding changes, and appropriate claims submission processes.
Liaise with reimbursement hotlines regarding alternative funding or financial assistance programs.
Assist with determining coverage and access options for a specific medication or procedure.
Engage with Medicare Advisory Carriers, MACs, and Monitor Local Coverage Determinations to ensure coverage aligns with product labeling.
Collaborate with internal partners to build strategic patient access and reimbursement account plans; stay informed on customer and industry trends and adapt capabilities to increase impact.
Support achievement of customer and product strategies by working with a broad stakeholder team.
Provide customer insights and product trends to HQ to shape current and future strategies.
Analyze and measure key business drivers and objectives, including relationship effectiveness and value proposition for assigned customers.
Communicate with national commercial payers, PBMs, Medicaid, Medicare, clinical pathway organizations, payer-owned specialty pharmacies, product distribution updates, and state government affairs.
Ensure compliance with Health, Safety, Environment, Energy and Quality Management System requirements relevant to the role.
Requirements
Bachelor’s degree required; advanced degree preferred.
7+ years’ experience with specialty providers in reimbursement; experience with both private and public payers strongly preferred.
Technical knowledge of health care reimbursement from patient and provider perspectives (authorizations, J codes, billing, coding, prior authorizations, appeals, patient and provider support programs and HUB operations).
Knowledge of all phases of specialty pharmacy core services and connectivity to patient access complexity.
Knowledge of private payer, Medicare and Medicaid structures and reimbursement processes.
Strong business and clinical acumen with leadership abilities and the ability to lead without authority.
Excellent written and oral communication, with strong presentation skills for key stakeholders and decision-makers.
Strategic thinker with the ability to create action plans and resolve issues.
Ability to work with senior leaders across functional groups to build consensus and drive action.
Demonstrated success in account management and the ability to work independently.
Willingness to travel extensively (overnight, ~80% of the time) within the designated territory; must live near a major airport in the territory.
Additional Information Salary Range: $155,000 – $165,000 per year
Position is eligible to participate in a bonus plan with a target of 14% of base salary. Final pay determinations depend on experience, education, knowledge, skills, and abilities. Benefits include medical, dental, and vision coverage, life insurance, disability, 401(k) with company contribution, and wellness programs.
Fresenius Kabi is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, citizenship, immigration status, disabilities, or protected veteran status.
Employment type
Full-time
Job function
General Business
Industries
Pharmaceutical Manufacturing
Hospitals and Health Care
#J-18808-Ljbffr