Virtual Field Reimbursement Manager

Accountabilities: Engage healthcare providers and office staff to explain patient access pathways for prescribed specialty treatments, including initial coverage, insurance approvals, and reauthorization processes. Educate healthcare professionals on prior authorization and appeals procedures, including how to access relevant forms, submission processes, and renewal requirements. Provide guidance to field partners, including Clinical Specialists and District Managers, to strengthen their ability to navigate straightforward and moderately complex reimbursement challenges. Proactively identify and help resolve patient access and reimbursement issues within the assigned geography, following program guidelines and compliance requirements. Share factual process information with healthcare provider offices using protected health information (PHI) only when appropriate patient consent has been obtained. Act as a reimbursement subject matter expert for patient support services teams, providing guidance on assigned geographic areas and payer plans. Use approved educational resources, call guides, and FAQs to answer questions and support consistent communication. Review payer policies regularly and communicate local, regional, and national coverage insights to relevant stakeholders and leadership. Virtually manage assigned accounts and coordinate with key stakeholders to identify and address ongoing support needs. Maintain accurate and complete call records, ensuring data integrity and compliance with program policies and business rules. Use CRM platforms and internal systems to document interactions and manage daily activities. Protect the confidentiality of patient information and comply with applicable laws, regulations, and organizational policies. Identify and escalate complex or appropriate cases to manufacturer leadership in accordance with established program procedures. Complete all required training and consistently follow applicable policies, procedures, business rules, and call guides. Requirements: Bachelor's degree (BS/BA) required. At least 3 years of relevant experience in reimbursement and patient access, market access, specialty pharmacy, or physician/system account management, alongside 5 or more years of total healthcare industry experience. Demonstrated success working in a virtual environment. Experience engaging healthcare provider staff in a support or educational capacity, particularly regarding patient access pathways and product requirements. Strong understanding of payer reimbursement processes, including commercial insurance and Medicare Part D pharmacy benefit design and coverage policies. Experience with specialty products distributed through specialty pharmacy networks. Background in ophthalmology and self-injectable treatments is preferred. Patient-focused and service-oriented mindset, with strong emotional intelligence and empathy. Excellent interpersonal, active listening, and relationship-building skills. Strong written and verbal communication abilities, including presentation skills. Sound business acumen and the ability to understand complex reimbursement and access challenges. Collaborative approach, with the ability to work toward shared goals alongside therapeutic specialists, sales leadership, market access teams, and patient support services colleagues. Strong organizational and multitasking skills, with exceptional attention to detail when supporting both patients and healthcare providers. Proficiency in Microsoft Office applications, including Word, Excel, PowerPoint, and Outlook, as well as Google Workspace tools. English proficiency required; Spanish language skills highly preferred. Benefits: Competitive annual base salary ranging from $98,000 to $182,000, depending on experience, skills, internal equity, and business needs. Comprehensive medical, dental, and vision insurance. Accrued paid time off. 401(k) retirement plan with company matching. Disability and life insurance coverage. Paid maternity and paternity leave. Company-paid holidays. Recognition programs, contests, and awards celebrating employee contributions. Ongoing learning opportunities, leadership development, and career advancement support. Collaborative working environment where ideas and contributions are valued.