Field Reimbursement Manager

Field Reimbursement Manager :

The Field Reimbursement Manager (FRM) plays a critical role in facilitating patient access to therapy by navigating complex reimbursement landscapes.

Operating within a designated territory, the FRM provides expert guidance on benefit investigations, prior authorizations, claims resolution, and appeals.

This client- and customer-facing role requires strong relationship-building skills with healthcare providers and manufacturer partners.

The FRM delivers tailored education and support both virtually and on-site, ensuring optimal utilization of reimbursement services.

This position demands a high level of autonomy, strategic thinking, and collaboration with internal hub services to meet evolving customer needs.

Key Responsibilities

1. Act as a strategic reimbursement advisor and primary liaison for healthcare providers, proactively identifying and resolving complex access and reimbursement barriers for assigned therapies.

2. Lead the resolution of high-impact reimbursement cases by overseeing benefit investigations, prior authorizations, claims escalations, and appeals, ensuring timely patient access.

3. Design and deliver advanced payer insights tailored to provider needs, incorporating evolving policy trends and access strategies across remote and in-person platforms.

4. Cultivate and expand strategic partnerships with key provider offices and manufacturer stakeholders to align support services with evolving customer and market dynamics.

5. Drive cross-functional collaboration with internal hub operations, analytics, and client teams to optimize service delivery and elevate the provider and patient experience.

6. Plan and facilitate high-value site engagements, including manufacturer-sponsored training and regional educational forums, to enhance provider readiness and adoption.

7. Serve as a subject matter expert on Medicare and commercial payer structures, translating complex benefit data into actionable insights for stakeholders.

8. Represent the FRM function in field-based initiatives, territory planning, and stakeholder engagement strategies to maximize visibility and impact.

9. Oversee territory-level project execution and account coordination, ensuring alignment with client KPIs, compliance standards, and program milestones.

10. Operate with a high degree of autonomy in a dynamic, client-facing environment, consistently delivering results under tight timelines and shifting priorities.

11. Lead documentation and reporting of all field activities in the FRM CRM system, ensuring data integrity and visibility for internal and client stakeholders.

Minimum Job Qualifications Education / Training :

• 4-year degree in related field or equivalent experience Business Experience :
• Entry-level experience in project management
• Minimum of 8 years healthcare related reimbursement experience
• Strong medical reimbursement experience with Buy & Bill and / or Specialty Pharmacy.
• Experience supporting program specific drug therapy space, i.e., oncology, dermatology, etc.
• Experience in the healthcare industry including, but not limited to insurance verification, prior authorizations, and / or claim adjudication, physician’s office or clinics.
• Must have Medicare and commercial insurance coverage experience.
• Must be able to deliver and document benefit investigation outcomes and relay status reports on a regularbasis.
• Strong customer service experience
• Proven presentation skills and experience
• Ability to effectively handle multiple priorities within a changing environment.
• Excellent organizational skills
• Strong Computer literacy to include PowerPoint and Web Meeting experience. Specialized

Knowledge / Skills :

Working Conditions :

Travel Requirements :

Physical Requirements :