Field Reimbursement Manager - Hartford, CT

Territory covers Connecticut and Rhode Island. This role supports the Respiratory business unit. Relocation is not offered.

About the role

At Amgen, our shared mission—to serve patients living with serious illnesses—drives all that we do. Since 1980, we’ve helped pioneer the world of biotech in our fight against the toughest diseases. With a focus on Oncology, Inflammation, General Medicine, and Rare Disease, we reach millions of patients each year. As a Field Reimbursement Manager (FRM), you’ll manage defined accounts within a specified geographic region, ensuring patient access and reimbursement for Amgen’s products. This role involves executing the collaborative territory strategic plan, resolving patient-level reimbursement issues, and educating healthcare providers on payer coverage and access.

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 when sites request assistance resolving coverage challenges.
• 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 on access processes, 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 geography for customer appointments.
• Remote, work-from-home 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 two years of experience in public or private third-party access arena or pharmaceutical industry in managed care, clinical support, and/or sales.
• Strong medical reimbursement experience and/or Specialty Pharmacy and Buy & Bill knowledge.
• Proven presentation and facilitation skills.
• Strong written and oral communication skills.
• Organizational skills 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’s offices or clinics, pharmacies, and/or pharmaceutical manufacturers.
• Proven experience with hubs and in-depth knowledge of billing, coding, and appeals across physician types.
• Strong collaboration and ability to lead cross-functional partner meetings.
• Experience with commercial payers, Medicare plans, and state Medicaid in a geographic region.
• Live in the geography or less than 10 miles from the geography border.

Qualifications

Basic Qualifications:

• 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.

In addition to meeting at least one of the above requirements, you must have experience directly managing people and/or leadership experience leading teams, projects, programs, or directing the allocation of resources.

Preferred Qualifications:

• Bachelor’s degree in business, healthcare, or a related field.
• 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 for buy & bill products and Part D for Pharmacy products).
• Ability to manage ambiguity and problem-solve.
• Ability to manage expenses within allocated budgets.

Benefits

Amgen offers a comprehensive employee benefits package, including:

• A Retirement and Savings Plan with generous company contributions.
• Group medical, dental, and vision coverage, life and disability insurance, and 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.

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.