FRM Field Reimbursement Manager, MO IL IN - Continuous Learning Opportunities

FIELD REIMBURSEMENT MANAGER (Specialty drugs and or Buy & Bill Drugs) MO, IL, IN   (major cites:  St Louis, MO; Springfield, IL; Indianapolis, IN.  

START May 28th, 2024    $100-108K 

Travel territory position, visiting provider offices all around this territory

MUSTS: Expert level in Prior Authorizations for Specialty Drugs, Access and Reimbursement , Patient Access to drug therapies. Newly launched specialty drug (already launched). CoverMyMeds experience , and some kind of field experience.

Live in:   St Louis, MO or Springfield, IL or Indianapolis IN   based out of your home , travel to provider offices around your territory

Key Responsibilities:

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 

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
• CoverMyMeds

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 Days are Tues, Wed, Thurs (by car or flight). Arrange your own appointments within your territory. Emphasis is on live in-person office visitations. Usually Tu - Thur with Mondays and Fridays your at home office days

Minimum Requirements

• 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 RELATED EXPERIENCE (WE LIKE THE 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

Interviewing immediately for MAY 28, 2024 start . Email me directly at [email protected]