Field Reimbursement Manager
The Field Reimbursement Manager (FRM) is responsible for managing an assigned territory focused on supporting Reimbursement and Patient services by providing assistance with patient reimbursement challenges for a specific drug (including Benefit Investigation, Prior Authorization, Claims Assistance, and Appeals) and educating the office on Payer landscape and services available through both remote interaction and on-site training.
This position is client facing and customer-facing and requires the ability to build relationships with physician offices as well as manufacture representatives to effectively deliver services based on customer specific preferences.
The Field Reimbursement Manager works independently in a fast paced, highly visible environment as well as collaboratively with the internal program hub support services to ensure all customer needs are met.
FRM will frequently interact via telephone with providers and internal staff to arrange site visits, Manufacturer trainings, and educational training venues.
Must have a solid working knowledge of Medicare and Commercial insurance plans and benefit structures in order to relay detailed benefit information and maximize the customer experience.
Position will require travel, project management and / or account coordination based on client expectation.
Key Responsibilities
- Act as a strategic reimbursement advisor and primary liaison for healthcare providers, proactively identifying and resolving complex access and reimbursement barriers for assigned therapies.
- Lead the resolution of high-impact reimbursement cases by overseeing benefit investigations, prior authorizations, claims escalations, and appeals, ensuring timely patient access.
- Design and deliver advanced payer insights tailored to provider needs, incorporating evolving policy trends and access strategies across remote and in-person platforms.
- Cultivate and expand strategic partnerships with key provider offices and manufacturer stakeholders to align support services with evolving customer and market dynamics.
- Drive cross-functional collaboration with internal hub operations, analytics, and client teams to optimize service delivery and elevate the provider and patient experience.
- Plan and facilitate high-value site engagements, including manufacturer-sponsored training and regional educational forums, to enhance provider readiness and adoption.
- Serve as a subject matter expert on Medicare and commercial payer structures, translating complex benefit data into actionable insights for stakeholders.
- Represent the FRM function in field-based initiatives, territory planning, and stakeholder engagement strategies to maximize visibility and impact.
- Oversee territory-level project execution and account coordination, ensuring alignment with client KPIs, compliance standards, and program milestones.
- Operate with a high degree of autonomy in a dynamic, client-facing environment, consistently delivering results under tight timelines and shifting priorities.
- 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 experienceBusiness Experience :
Entry-level experience in project managementMinimum of 8 years healthcare related reimbursement experienceStrong medical reimbursement experience with Buy & Bill and / or Specialty PharmacyExperience 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 clinicsMust have Medicare and commercial insurance coverage experienceMust be able to deliver and document benefit investigation outcomes and relay status reports on a regular basisStrong customer service experienceProven presentation skills and experienceAbility to effectively handle multiple priorities within a changing environmentExcellent organizational skillsStrong Computer literacy to include PowerPoint and Web Meeting experienceSpecialized Knowledge / Skills :
Previous field experience, a plusPrevious experience with specialty pharmacy a plusAccount management experience, a plusExcellent Interpersonal skillsExcellent written and oral communication skillsProblem solving and decision-making skills