Field Reimbursement Manager – Mid Atlantic

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $134.6k - $201.3k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

👻 Ghost score 0%

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Otsuka Pharmaceutical Companies (U.S.)

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

💊 Pharmaceuticals

🏥 Healthcare

🧬 Biotechnology

Pharmaceuticals • Healthcare • Biotechnology

Otsuka Pharmaceutical Companies (U. S. ) is a prominent player in the pharmaceutical manufacturing industry, dedicated to creating innovative products for better health worldwide. The company comprises two main entities: Otsuka America Pharmaceutical, Inc. (OAPI), which is focused on commercializing Otsuka-discovered and in-licensed products in North America, and Otsuka Pharmaceutical Development & Commercialization, Inc. (OPDC), which specializes in the clinical development and global registration of innovative healthcare solutions, particularly in the field of neuroscience.

📋 Description

• Serve as the subject-matter expert on reimbursement, access, and coverage issues for products, primarily in Nephrology and Rare Disease • Act as a liaison between healthcare providers, internal teams, and external stakeholders to facilitate patient access • 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 care sites • Execute collaborative territory plans with internal and external stakeholders • Review and educate offices on payer policies, including prior authorization requirements • Provide feedback to internal teams on local payer trends and access issues • Assist in resolving patient-specific coverage challenges when requested by healthcare providers

🎯 Requirements

• Bachelor's degree • 5+ years of pharmaceutical industry experience, with focus on payer policy and reimbursement • 3+ years of experience in benefit verifications, prior-authorization requirements, or equivalent experience in patient access, billing, and coding in rare disease • 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 • 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 • Ability to travel up to 60-70% domestically • Valid driver's license required

🏖️ Benefits

• 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