Field Reimbursement Manager

About the role

McKesson is an impact-driven, Fortune 10 company that touches virtually every aspect of healthcare. We are known for delivering insights, products, and services that make quality care more accessible and affordable. The CoverMyMeds Field Reimbursement Manager (FRM) is responsible for managing an assigned territory focused on supporting Reimbursement and Patient services by providing assistance with patient reimbursement challenges for a specific drug (including Benefit Investigation, Prior Authorization, Claims Assistance, and Appeals) and educating the office on Payer landscape and services available through both remote interaction and on-site training. This position is client-facing and customer-facing and requires the ability to build relationships with physician offices as well as manufacturer representatives to effectively deliver services based on customer specific preferences. The Field Reimbursement Manager works independently in a fast paced, highly visible environment as well as collaboratively with the internal program hub support services to ensure all customer needs are met.

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.
• Educate on Benefit Investigation, Prior Authorization Process, Support Center Services, Medicare and Commercial coverage and patient communication streams.
• Provide 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.
• Responsible for setting up appointments and completing outbound calls to targeted offices. Assist in completing backlog casework. Additional day-to-day in-office work.
• Interface with physicians and manufacturer representatives to obtain and provide patient and provider specific information.
• Monitor program performance for physicians and manufacturer representatives in accordance with expectations.
• Research and compile provider / manufacturer representative specific information for reimbursement database.

Requirements

• 4-year degree in related field or equivalent experience
• 4+ years of healthcare related reimbursement experience
• Strong medical reimbursement experience with Buy & Bill and/or Specialty Pharmacy
• 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

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

Working Conditions

• General office demands – Remote, WFH
• Must reside in territory – Madison, WI, Minneapolis, MN or Milwaukee, WI area
• 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
• Possible long periods of sitting and/or keyboard work

Pay

Our Base Pay Range for this position is $80,300 – $133,800.