Field Reimbursement Manager - Cheyenne WY

Requisition Number

447015BR

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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.

Tezspire Field Reimbursement Manager (FRM)

Live

What you will do

The Tezspire Field Reimbursement Manager (FRM) will manage defined accounts within a specified geographic region in the respiratory therapeutic area. This role involves supporting our products by executing the collaborative territory strategic plan. The FRM 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).

Key Responsibilities:

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.

Minimum Education Required

Associates

Job Category

Scientific Research & Development

Additional Qualifications/Responsibilities

What we expect of you

We are all different, yet we all use our unique contributions to serve patients

Minimum Job Qualifications:

Minimum two years of experience in public or private third-party access arena or pharmaceutical industry in managed care, clinical support, and/or sales

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

Proven experience with hubs and in-depth knowledge of issues related to billing, coding, and appeals across physician types

Strong collaboration and ability to lead cross functional partner meetings

Experience with commercial payers, Medicare plans, and state Medicaid in a geographic region

Preferred Qualifications:

Bachelor's degree in business, healthcare, or a related field

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

Working Conditions:

General office demands – Remote, Work from Home.

One to two home office days per week.

Must be able to travel up to 60-70% 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.

Job Code

Pharmaceutical Pharmaceutical

Company

Amgen