OneTrust

Flex Field Reimbursement Manager

OneTrust

full-time

Posted on:

Location Type: Hybrid

Location: Denver • Colorado • United States

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Salary

💰 $102,000 - $153,000 per year

About the role

  • Educate HCPs on product coverage, prior authorizations and appeals, reimbursement processes, claims submissions, procedures, and coding requirements of payer organizations (local payers, government payers, etc.) for core and launch products.
  • Collaborate with field support team members such as sales representatives and key account managers and serve as reimbursement expert for the local team.
  • Act with a sense of urgency to address critical access and affordability issues for patients.
  • Partner with managed care colleagues to understand current policies and potential future changes.
  • Conduct field-based reimbursement and access support, education and creative problem-solving aligned to FRM Rules of Engagement
  • Build strong, trust-based relationships with customers in all assigned Immunology accounts.
  • Manage territory logistics, routing, and account business planning.
  • Maintain and grow knowledge of national, regional, local, and account market dynamics including coverage and coding requirements.
  • Grow the knowledge of hub and specialty distribution channels to improve practice and patient support needs.
  • Collaborate with internal J&J departments such as marketing, sales, medical science, SCG, IBG, HCC, and PECS. Serve as subject matter expert regarding education and insights on access and affordability solutions across multiple payer types and plans (i.e., Medicare, Medicaid Managed Care, Commercial).
  • Execute business in accordance with the highest ethical, legal, and compliance standards, including timely and successful completion of all required training.
  • Extensive knowledge of medication access channels (i.e., pharmacy and medical benefits including buy & bill and/or assignment of benefit (AOB) across multiple sites of care
  • Remains current on and anticipates changes in product coverage and access knowledge, marketplace conditions, and stakeholder practices to deliver the most effective delivery of approved materials.
  • Understands and adapts to the changing healthcare ecosystem to customize resourcing and messaging to HCPs and HCP staff

Requirements

  • Bachelor’s degree (preferably in healthcare or business/public administration).
  • Minimum of 5 years of relevant professional experience
  • Account Management and/or Reimbursement experience working in the hospital and/or provider office setting, building strong customer relationship.
  • Demonstrated expertise with both pharmacy and medical/buy & bill benefits (as applicable), coding, and billing.
  • Reimbursement or relevant managed care experience (revenue cycle, buy-and-bill, prior authorization, coding, and appeals processes)
  • Ability to establish relationships, collaborate, and influence across a matrix organization.
  • Problem-solving ability to navigate challenging access scenarios and identifies solutions in a timely and efficient manner.
  • Experience in working with patient support HUB services.
  • Valid US driver’s license and a driving record in compliance with company standards
  • Ability to consistently maintain up to 50% travel.
  • Permanent residence in the listed territory
Benefits
  • medical
  • dental
  • vision
  • life insurance
  • short- and long-term disability
  • business accident insurance
  • group legal insurance
  • consolidated retirement plan (pension)
  • savings plan (401(k))
  • long-term incentive program
  • Vacation –120 hours per calendar year
  • Sick time - 40 hours per calendar year; for employees who reside in the State of Washington –56 hours per calendar year
  • Holiday pay, including Floating Holidays –13 days per calendar year
  • Work, Personal and Family Time - up to 40 hours per calendar year
  • Parental Leave – 480 hours within one year of the birth/adoption/foster care of a child
  • Condolence Leave – 30 days for an immediate family member: 5 days for an extended family member
  • Caregiver Leave – 10 days
  • Volunteer Leave – 4 days
  • Military Spouse Time-Off – 80 hours
Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools
reimbursement processesclaims submissionscoding requirementsprior authorizationbuy & billrevenue cyclecodingbillingpatient support HUB servicesaccount business planning
Soft Skills
relationship buildingcollaborationinfluenceproblem-solvingcommunicationurgencytrust-buildingcreative problem-solvingadaptabilitycustomer relationship management
Certifications
Bachelor’s degree in healthcareBachelor’s degree in business administrationvalid US driver’s license