Field Reimbursement Manager – Rockies

🕒 Ontem

⛰️ Colorado, Texas, +1 estados a mais – Remoto

⛰️ Colorado – Remote 🤠 Texas – Remote ⛷️ Utah – Remote

💵 $150.034 - $224.250 / ano

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

👔 Gerente

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Otsuka Pharmaceutical Companies (U.S.)

SiteLinkedInTodas as Vagas

1001 - 5000 funcionários

💊 Farmacêutico

🏥 Saúde

🧬 Biotecnologia

Pharmaceuticals • Healthcare • Biotechnology

As Empresas Farmacêuticas Otsuka (EUA) são um ator proeminente na indústria de fabricação farmacêutica, dedicadas a criar produtos inovadores para uma melhor saúde em todo o mundo. A empresa é composta por duas entidades principais: a Otsuka America Pharmaceutical, Inc. (OAPI), que se concentra na comercialização de produtos descobertos e licenciados pela Otsuka na América do Norte, e a Otsuka Pharmaceutical Development & Commercialization, Inc. (OPDC), que é especializada no desenvolvimento clínico e registro global de soluções inovadoras em saúde, particularmente na área de neurociências.

Descrição

• Serve as the subject-matter expert on reimbursement, access, and coverage issues for products, primarily in Nephrology and potentially other therapeutic areas • Act as a liaison between healthcare providers, internal teams, and external stakeholders to facilitate patient access to products • Educate healthcare providers and staff on access, coverage, reimbursement processes, claims submissions, and coding requirements • Analyze payer criteria and provide product access expertise to healthcare offices • Coordinate with Hubs on individual patient cases, patient support services, and enrollment • Collaborate with Field Sales, Specialty Pharmacy Accounts, and other matrix partners • Manage daily field-based activities, spending 60-70% of time interacting with key stakeholders across various care sites • Execute collaborative territory plans through internal and external partnerships • Review and educate offices on payer policies, including prior authorization requirements • Provide feedback to internal teams on local payer trends and access issues • Assist with patient-specific coverage challenges when requested by healthcare providers

🎯 Requisitos

• Bachelor's degree required • Minimum 5 years of pharmaceutical industry experience, with focus on payer policy and reimbursement preferred • At least 3 years of experience in benefit verifications, prior-authorization requirements, or equivalent experience in patient access, billing, and coding in rare disease preferred • Strong knowledge of Centers for Medicare & Medicaid Services (CMS) policies and processes, especially Medicare Part D • Experience in "Buy and Bill" reimbursement environment • Nephrology experience strongly preferred • Comprehensive understanding of US healthcare system payer billing practices • Proficiency in MS Office suite • Excellent verbal and written communication skills • Strong interpersonal and consultative abilities • Self-directed with outstanding organizational skills • Ability to build and maintain strong relationships with internal and external customers • Proficient in delivering training and presentations • Ability to travel up to 60-70% domestically • Valid driver's license required

🏖️ Benefícios

• Comprehensive medical, dental, vision, and prescription drug coverage • Company-provided basic life insurance • Accidental death and dismemberment insurance • Short-term and long-term disability insurance • Tuition reimbursement • Student loan assistance • Generous 401(k) match • Flexible time off • Paid holidays • Paid leave programs • Other company-provided benefits • Incentive opportunity

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