Job Opening: FRM Field Reimbursement Manager, Detroit
FIELD REIMBURSEMENT MANAGER (Specialty drugs and or Buy & Bill Drugs) DETROIT, MI
START mid MARCH 2024 $105K to 110K (yes that is really the pay)
Travel territory position, visiting provider offices all around DETROIT
A MUST : Expert level in Prior Authorizations for Specialty Drugs, Access and Reimbursement , Patient Access to drug therapies. Newly launched specialty drug (already launched). Some kind of field experience.
Live in Detroit area , based out of your home , travel to provider offices around the territory ( Detroit area )
Provide on-demand education (in-person and virtual) for the doctor’s office staff in regard to Reimbursement challenges and support services that are available for these Specialty Drugs and Buy & Bill drugs.
Educate the provider’s office team:
- Benefit Investigation / Prior Authorization Process for the specialty drugs.
- Support Center Services (hub)
- Medicare and Commercial coverage
- Educate on the patient communication streams
Provide Reimbursement Support:
- Drug Therapy Case management
- Billing and coding updates
- Appropriate claims submission
- Specialty Pharmacy
- Medical Benefit Interpretation
- Understanding medical necessity
- Claims / Appeal assistance
- Information related to co-pay assistance programs
- Information related to patient assistance programs
Responsible for managing your territory: making outbound calls to set up appointments to targeted offices.
- In person and in virtual meetings and calls: Interface with physician’s Office Staff and MA’s and Drug Manufacturer Reps to obtain and provide patient and provider specific information.
- Assist in completing backlog casework.
- Monitor program performance for physicians and manufacturer representatives in accordance with expectations.
- Research and compile provider / manufacturer representative specific information for reimbursement database.
- Travel M-Th (by car or flight). Arrange your own appointments within your territory. Emphasis is on live in-person office visitations. Usually Mon- Thur with Fridays your at home office day
- This is a good role for an FRM looking for stability
- This is a good role for someone focused on Patient Access for drug therapies , someone who has worked their way up in PBM hub services, Specialty Pharmacy PA Coordinator or manager, RN’s. Great next step to build on your career.
- I’m looking for candidates with some kind of field/territory experience because that is the whole point of a Field Reimbursement Manager.
- BA degree or equivalent in related work experience.
- 2+ years specialty drug related reimbursement experience, reimbursement advocacy
- Medical reimbursement experience with Buy & Bill and/or Specialty Pharmacy.
- Insurance verification, prior authorizations, and/or claim adjudication, physician’s office or clinics.
- Medicare and commercial insurance coverage experience.
- Deliver and document benefit investigation outcomes and relay status reports on a regular basis.
- Ability to effectively handle multiple priorities within a changing environment.
- Strong Computer literacy, including MS Teams, PowerPoint, Web Meeting experience
Summary – the best candidate for this role will have advanced knowledge in SPECIALTY DRUG PA’s, denials, appeals, payer knowledge, coding, J-Codes, and EOBs, patient co-pay assistance, coupled with experience educating staff on complex PA process’.
Interviewing immediately for an mid March start . Email me directly at email@example.com