Field Reimbursement Manager

Key Responsibilities

• Provide on-site and on-demand education (including Lunch and Learns or Dinner presentations) for the office staff in regard to Reimbursement challenges and support services that are available.
• Office interaction will include education and reimbursement support. On-site/virtual interactions will average 15 per week. These activities are recorded in FRM CRM daily with reporting to manager weekly.
• Educate on Benefit Investigation, Prior Authorization Process, Support Center Services, Medicare and Commercial coverage and patient communication streams.
• Monthly activity reporting captures educational topics at FRM level reportable to client based on client expectation. This trended data is also reported quarterly to client.
• Reimbursement Support on Case management, billing and coding updates, appropriate claims submission, Specialty Pharmacy, Medical Benefit Interpretation, understanding medical necessity, claims and appeal assistance, information related to co-pay assistance and patient assistance programs.
• FRM will collaborate with case manager on average of 4/month and ad hoc as needed for escalations. These interactions are tracked in FRM CRM and hub system.
• Absorb and complete backlog casework.
• Interface with physicians and manufacturer representatives to obtain and provide patient and provider specific information.
• All FRM interactions/activities are tracked in FRM CRM which are reportable to management and client.
• Monitor program performance for physicians and manufacturer representatives in accordance with expectations.
• Territory performance will be monitored via FRM CRM dashboard daily. Trending results will be identified through quarterly reporting. Additionally, clients have the option to survey customers on program performance.
• Research and compile provider / manufacturer representative specific information for reimbursement database. (Includes account profiles)
• FRM will create a facility database on each new provider in FRM CRM. All interactions/activities are built utilizing this database.

  Minimum Job Qualifications

  • 4-year degree in related field or equivalent experience
  • 4+ years of healthcare related reimbursement experience
  • Business Experience – Strong medical reimbursement experience with Buy & Bill and/or Specialty Pharmacy
  • Experience supporting oncology products preferred
  • Experience in the healthcare industry including, but not limited to insurance verification, prior authorizations, and/or claim adjudication, physician’s office or clinics
  • Must have Medicare and commercial insurance coverage experience
  • Must be able to deliver and document benefit investigation outcomes and relay status reports on a regular basis
  • Proven presentation skills and experience
  • Proven ability to effectively handle multiple priorities and excellent organizational skills
  • Strong Computer literacy to include PowerPoint and Web Meeting experience

    Specialized Knowledge/Skills

    • Previous field experience, a plus
    • Previous experience with specialty pharmacy a plus
    • Account management experience, a plus
    • Excellent Interpersonal skills
    • Excellent written and oral communication skills
    • Problem solving and decision-making skills

      Travel Requirements

      • Looking for candidates in the following: Columbus, Dayton, Cleveland, Toledo, Akron, OH
      • Must reside in territory
      • Must be able to travel 80% (4 days a week) via automobile or plane
      • Must have a valid driver's license with a clean driving record/ MVR

        Physical Requirements

        • Possible long periods of sitting and/or keyboard work
        • General office demands

          Pay Range

          $80,300 - $133,800

          Note: This pay range is aligned with McKesson's pay philosophy and pay will always be compliant with any applicable regulations.

          In addition to base pay, other compensation, such as an annual bonus or long-term incentive opportunities may be offered.

          For more information regarding benefits at McKesson, please click here.

          Our Base Pay Range for this position $80,300 - $133,800