Field Reimbursement Manager

Description

Responsibilities

The Field Reimbursement Manager (FRM) will operate as the subject-matter expert on reimbursement, access, and coverage issues affecting the clients products. Educate HCPs and their staff on matters related to reimbursement, access and coverage to facilitate appropriate patient access. The FRM will analyze reimbursement and access issues and act as the local access and reimbursement resource for other field sales force personnel and region management. Coordinate with the Hub concerning individual patient cases including patient reimbursement assistance, referrals to enrollment to product shipment, and overall coordination. The FRM will need to collaborate cross functionally with Field Sales, Marketing, Market Access, Public Affairs, State & Government Affairs, Trade, and Specialty Pharmacy Accounts while abiding by all corporate and industry policy and procedures.

• Analyze access & reimbursement issues and opportunities
• Educate office personnel on the Patient Journey for assigned product(s)
• Provide offices product access & reimbursement expertise
• Provide access & reimbursement education to field teams etc.
• Coordinate on access & reimbursement issues with third parties including Hubs / Patient Support Services
• Liaising with Specialty Pharmacy for pharmacy benefit products
• Educate HCPs on reimbursement processes claims submissions, procedures and coding requirements of payer organizations (local payers, government payers, etc.)
• Provide information to HCP on how the products are covered under the benefit design (Commercial, Medicare Part D, Medicaid)
• Answer questions about coverage, ICD-10 codes, and specific product codes, including patient-specific access questions
• Educate and update HCPs on key private and public payer coverage and changes that impact the products access for patients
• Support patient access to the products by providing subject matter expertise on reimbursement issues that may be barriers to product access in a manner that complies with policies, processes, and standard operating procedures
• Educate HCPs and their practice personnel on the products Hub / Patient Support Services program including reimbursement, financial assistance and Hub tools (e.g. provider portal tool, copay tracking, forms)
• Demonstrate knowledge of and communicate information about resources and forms available for access and reimbursement

Job Requirements

Along with a results-oriented mindset, self-assurance and an engaging manner, the ideal candidate has:

• BS/BA required.
• 5 years of pharmaceutical and/or biotech experience
• 2 years of relevant experience in the following: patient journey navigation, payer, reimbursement, medical billings & coding, specialty pharmacy & distribution, and patient support services engagement
• Experience with Neurology and infused products preferred
• Buy and bill experience required
• Experience with IDNs, Health Systems and Infusion Centers preferred
• Must have an in-depth understanding of Patient Enrollment Forms; Prior Authorization process; Appeals; Peer to Peer interventions; coding, coverage, and payment across all sites of care (e.g., offices, clinics, hospital)
• Demonstrated ability to solve access issues related with both specialty pharmacy products and medical benefit products
• Strong communication & collaboration skills with matrix field partners
• Effective presentations skills for both one-on-one and large group settings
• Ability to navigate informational dashboards and Excel spreadsheets
• Demonstrated passion for solving issues
• Ability to travel up to 70%

At Syneos Health, we are dedicated to building a diverse, inclusive and authentic workplace. If your past experience doesn’t align perfectly, we encourage you to apply anyway. At times, we will consider transferable skills from previous roles. We also encourage you to join our Talent Network to stay connected to additional career opportunities.

Why Syneos Health? Our ability to collaborate and problem-solve makes a difference in patients’ lives daily. By joining one of our field access teams, you will partner with industry experts and be empowered to succeed with the support, resources, and autonomy needed to successfully navigate the complex reimbursement landscape. The diversification and breadth of our new and existing partnerships create a multitude of career paths and employment opportunities. Join our game-changing, global company dedicated to creating better, smarter, faster ways to get biopharmaceutical therapies to patients Experience the thrill of knowing that your everyday efforts are contributing to improving patients' lives around the world.

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Syneos Health companies are affirmative action/equal opportunity employers (Minorities/Females/Veterans/Disabled)

Syneos Health has a voluntary COVID-19 vaccination policy. We strongly encourage all employees to be fully vaccinated. Additionally, certain local governments or Syneos Health customers may have vaccine requirements that apply to some of our employees. These employees are required to submit proof of vaccination to Syneos Health and maintain compliance with these requirements.
At Syneos Health, we believe in providing an environment and culture in which Our People can thrive, develop and advance. We reward and recognize our people by providing valuable benefits and a quality-of-life balance. The benefits for this position will include a competitive compensation package, Health benefits to include Medical, Dental and Vision, Company match 401k, flexible paid time off (PTO) and sick time. Because certain states and municipalities have regulated paid sick time requirements, eligibility for paid sick time may vary depending on where you work. Syneos Health complies with all applicable federal, state, and municipal paid sick time requirements.