Field Reimbursement Manager - Central / Midwest

The Field Reimbursement Manager (FRM) will work as a field-based patient access and reimbursement specialist in an assigned region that provides appropriate support to providers and professional staff to help facilitate access to Assertio products as a regular FRM. The FRM will leverage in-depth expertise in reimbursement coding, billing, payer coverage, patient assistance, healthcare policy and Assertio support programs to help minimize barriers to patient access.

Essential Functions

• Assist oncology HCPs and staff in resolving reimbursement issues/barriers that comply with Assertio policies, processes and guidelines.
• The FRM will serve as a regional expert providing assistance and proactive education to key oncology offices regarding all aspects of reimbursement, payer access and patient support programs.
• The FRM will work with all engaged sites of care including Oncology clinics, hospitals, and Oncology Networks.
• Conduct meetings as needed with key office staff to learn about patient reimbursement challenges and proactively educate them on Assertio reimbursement support for company products.
• Demonstrate extensive knowledge of regional and national payer landscapes with expertise in reimbursement policy, utilization management criteria, prior authorization processes and appeal requirements.
• The FRM will be an expert at compiling and deciphering local territorial and state payer policies.
• Serve as a subject matter expert on access and reimbursement processes pre/post CMS C-Code and J-Code status (i.e., knowledge of launching a product with a misc. J code).
• Function as a field-based extension of our HUB vendor.
• Develop ongoing interaction with clients in a manner that anticipates and adapts to customer reimbursement support needs as well as market changes/challenges.
• The FRM will demonstrate extensive knowledge of specialty payer landscape, the appropriate utilization of NCCN/ASCO guidelines, private payer, GPOs, Medicare and Medicaid structure, Specialty Pharmacy systems and the buy-and-bill dynamics for medical benefits.
• Leverage data from multiple systems (Focal Point Claims Database, HUB Fusion insights platform, CRM) and account engagements to provide strategic coverage/reimbursement leadership and support to Assertio leadership and Field Sales Leadership to which their geographies align.
• Individual must be able to travel extensively within their region and sometimes nationally.
• The FRM will have excellent interpersonal and communication skills with HCP offices, clinics, hospitals and other FRM colleagues.
• Excellent presentation skills

Education/Experience

• Bachelor’s degree required (MBA is a plus) or Minimum of 8 years of experience with Specialty Pharmaceuticals/Biologics
• Field reimbursement experience required.
• Buy-and-bill and AOB experience required.
• Established relationships within HCP Offices in their territory required.
• Specialty Pharmacy experience a plus.
• Familiar with the Enhancing Oncology Model (EOM) a plus.
• Must be a true team player and work collaboratively with key internal stakeholders.
• In depth knowledge of pharmaceutical manufacturer compliance, patient confidentiality, product reimbursement and product access requirements.
• Knowledge of regulations and laws governing the protection of patient identifying information, and CMS policies pertaining to access services.
• Knowledge of CMS policies and processes with expertise in Part B & D (Medical/Pharmacy Benefit design and coverage policy).
• Strong strategic account management planning skills.

Position Location and/or Territory and Travel:

• Position is located in the assigned region (TX, LA, OK, AR, KS, MO, IL, IA, NE, WI, MN, ND, and SD). Territories may change due to business demands and/or as directed by Commercial Leadership.
• Position will require some travel at a national level
• Position will require >60% travel.

Physical Requirements

• Ability to operate a motor vehicle
• Ability to travel via airplane
• Ability to sit for long periods of time
• Ability to have close visual acuity to perform an activity such as: preparing and analyzing data and figures; transcribing; viewing a computer terminal.
• Reaching: Extending hand(s) and arm(s) in any direction.
• Standing: Remaining upright on the feet.
• Pushing: Using upper extremities to press against something with steady force in order to thrust
• Lifting: Raising objects from a lower to a higher position or moving objects horizontally from position-to-position of up to 20 lbs. on occasion

 Mental Requirements

• Ability to prepare and analyze data and figures
• Ability to understand, remember and apply oral and written instructions
• Ability to organize and prioritize own works schedule
• Ability to apply common sense in performing job
• Ability to understand and follow instructions

Accommodations for Applicants with Disabilities

Assertio is proud to create a culture of inclusion and diversity and be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity, national origin, genetics, disability, age, sexual orientation or veteran status. We provide reasonable accommodations to qualified applicants with disabilities and to disabled veterans in accordance with the ADA. If you require a reasonable accommodation for any part of the application process due to a medical condition or disability, please email hr@assertiotx.com or call 224-441-6867 for assistance.

For more information about your EEO rights as an applicant under the law, please click here.