Field Reimbursement Manager

Territory covers: Michigan (Flint, Lansing, Grand Rapids, Saginaw, Traverse City), Fort Wayne, IN and South Bend, IN. This role supports the Respiratory business unit.

About the role

Join Amgen’s mission to serve patients living with serious illnesses. Since 1980, Amgen has pioneered biotechnology to fight tough diseases across Oncology, Inflammation, General Medicine, and Rare Disease, reaching millions of patients annually. As a Field Reimbursement Manager (FRM), you will manage defined accounts within a specified geographic region, focusing on patient access and reimbursement. This role involves executing a collaborative territory strategic plan, ensuring understanding of reimbursement processes, and resolving patient-level reimbursement issues with knowledge of patient health information (PHI).

Responsibilities

• Act as an extension of the HUB, providing live one-on-one coverage support.
• Assist from physician order to reimbursement, supporting the entire reimbursement journey through payer prior authorization to appeals/denials requirements and forms.
• Review patient-specific information to resolve issues or coverage challenges when requested by the site.
• Educate and update healthcare providers (HCPs) on key private and public payer coverage changes impacting patient product access.
• Coordinate access/reimbursement issues with relevant partners, including the HUB.
• Provide information to HCPs on product coverage under benefit designs (Commercial, Medicare, Medicaid).
• Serve as a payer expert for the defined geography and communicate payer changes to key stakeholders.
• Offer office education during the access process, including formulary coverage, utilization management criteria, insurance forms, benefits investigation, prior authorization, appeal, and claims resolution.
• Educate offices using approved materials.
• Review patient insurance benefit options and alternate funding/financial assistance programs.
• Collaborate with other departments to resolve reimbursement issues.

Working Conditions

• 3 days a week in the assigned geography for customer appointments.
• Remote, work-from-home setup with 1-2 home office days per week.
• Must be able to travel up to 60-80% via automobile or plane.
• Must have a valid driver’s license with a clean driving record.
• Possible long periods of sitting and/or keyboard work.

Requirements

• Minimum qualifications (one of the following):
  • Doctorate degree, or
  • Master’s degree and 3 years of customer service and/or leadership experience, or
  • Bachelor’s degree and 5 years of customer service and/or leadership experience, or
  • Associate’s degree and 10 years of customer service and/or leadership experience, or
  • High school diploma/GED and 12 years of customer service and/or leadership experience.
• Experience directly managing people and/or leadership experience leading teams, projects, programs, or directing resource allocation.
• Minimum two years of experience in public or private third-party access, managed care, clinical support, and/or sales within the pharmaceutical industry.
• Strong medical reimbursement experience and/or knowledge of Specialty Pharmacy and Buy & Bill.
• Proven presentation and facilitation skills.
• Strong written and oral communication skills.
• Organizational and project management experience, including managing multiple projects.
• Strong computer literacy (Word, Excel, PowerPoint) and ability to conduct web-based meetings.
• Experience in the healthcare industry, including insurance verification, claim adjudication, physician offices, clinics, pharmacies, or pharmaceutical manufacturers.
• Proven experience with hubs and in-depth knowledge of billing, coding, and appeals across physician types.
• Strong collaboration skills and ability to lead cross-functional partner meetings.
• Experience with commercial payers, Medicare plans, and state Medicaid in a geographic region.
• Must live in the assigned geography or within 10 miles of the geography border.

Preferred Qualifications

• Bachelor’s degree in business, healthcare, or a related field.
• 6 years’ experience with specialty/biologic self-injectable (pharmacy benefit) or physician-administered (buy and bill/medical benefit) products.
• Advanced knowledge of medical insurance terminology.
• Knowledge of Centers for Medicare & Medicaid Services (CMS) policies and processes, with expertise in Medicare (Part B and Part D).
• Ability to manage ambiguity and problem-solve.
• Ability to manage expenses within allocated budgets.

Pay

The expected annual salary range for this role in the U.S. (excluding Puerto Rico) is $145,471.00 to $196,813.00. Actual salary will vary based on relevant skills, experience, and qualifications.

Benefits

• A comprehensive employee benefits package, including:
  • Retirement and Savings Plan with generous company contributions.
  • Group medical, dental, and vision coverage.
  • Life and disability insurance.
  • Flexible spending accounts.
• A discretionary annual bonus program (or sales-based incentive plan for field sales representatives).
• Stock-based long-term incentives.
• Award-winning time-off plans.
• Flexible work models, including remote and hybrid work arrangements where possible.