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Field Reimbursement Specialist

1 month ago

Hamtramck, Michigan, United States VetJobs Full time

Job Description

ATTENTION MILITARY AFFILIATED JOB SEEKERS - Our organization works with partner companies to source qualified talent for their open roles. The following position is available to Veterans, Transitioning Military, National Guard and Reserve Members, Military Spouses, Wounded Warriors, and their Caregivers. If you have the required skill set, education requirements, and experience, please click the submit button and follow the next steps. Unless specifically stated otherwise, this role is "On-Site" at the location detailed in the job post.

At Amgen, if you feel like you're part of something bigger, it's because you are. 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 world's toughest diseases. With our focus on four therapeutic areas -Oncology, Inflammation, General Medicine, and Rare Disease- we reach millions of patients each year. As a member of the Amgen team, you'll help make a lasting impact on the lives of patients as we research, manufacture, and deliver innovative medicines to help people live longer, fuller happier lives.

Our award-winning culture is collaborative, innovative, and science based. If you have a passion for challenges and the opportunities that lay within them, you'll thrive as part of the Amgen team. Join us and transform the lives of patients while transforming your career.

Field Reimbursement Specialist - Detroit, MI

What you will do
Let's do this. Let's change the world. In this vital role the Field Reimbursement Specialist (FRS) will manage defined accounts within a specified geographic region for Patient Access and Reimbursement. This role involves supporting products by executing the collaborative territory strategic plan. The FRS will ensure an understanding of the reimbursement process, field reimbursement services, and patient support programs. They will also work on patient-level reimbursement issue resolution, requiring knowledge and experience with patient health information (PHI).

Act as an extension of the HUB, providing live one-on-one coverage support
Offer assistance from physician order to reimbursement, supporting the entire reimbursement journey through payer prior authorization to appeals/denials requirements and forms
Review patient-specific information in cases where the site has specifically requested assistance resolving any issues or coverage challenges
Educate and update healthcare providers (HCPs) on key private and public payer coverage and changes that impact patient product access
Coordinate access/reimbursement issues with relevant partners, including the HUB
Provide information to HCPs on how the products are covered under the benefit design (Commercial, Medicare, Medicaid)
Serve as a payer expert for defined geography and promptly communicate payer changes to key stakeholders
Offer office education during the access process, including formulary coverage/utilization management criteria, insurance forms & procedures, benefits investigation, prior authorization, appeal, and/or 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, (geography specific)
General office demands - Remote, Work from Home.
One to two 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.

Additional Qualifications/Responsibilities

What we expect of you
We are all different, yet we all use our unique contributions to serve patients. The field reimbursement professional we seek is a collaborator with these qualifications.

Basic Qualifications:

Doctorate degree AND 2 years of experience in the public or private third-party access arena or pharmaceutical industry in managed care, clinical support, and/or sales

OR

Master's degree AND 6 years of experience in the public or private third-party access arena or pharmaceutical industry in managed care, clinical support, and/or sales

OR

Bachelor's degree AND 8 years of experience in the public or private third-party access arena or pharmaceutical industry in managed care, clinical support, and/or sales

OR

Associate degree AND 10 years of experience in the public or private third-party access arena or pharmaceutical industry in managed care, clinical support, and/or sales

Preferred Qualifications:

Bachelor's degree in business, healthcare, or a related field
6 years' 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 of 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
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 the ability to manage multiple projects
Strong computer literacy, including Word, Excel, and PowerPoint, and the 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
What you can expect of us
As we work to develop treatments that take care of others, we also work to care for your professional and personal growth and well-being. From our competitive benefits to our collaborative culture, we'll support your journey every step of the way.

The expected annual salary range for this role in the U.S. (excluding Puerto Rico) is $155,968.00 to $173,578 .00. Actual salary will vary based on several factors including, but not limited to, relevant skills, experience, and qualifications.

In addition to the base salary, Amgen offers a Total Rewards Plan, based on eligibility, comprising of health and welfare plans for staff and eligible dependents, financial plans with opportunities to save towards retirement or other goals, work/life balance, and career development opportunities that may include:

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 for field sales representatives, a sales-based incentive plan
Stock-based long-term incentives
Award-winning time-off plans
Flexible work models, including remote and hybrid work arrangements, where possible VetJobs