Field Reimbursement Manager - Pittsburg, PA
Amgen
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Upgrade to Pro — $25/moJoin Amgen’s Mission of Serving Patients
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. Amgen is advancing a broad and deep pipeline and portfolio of medicines to treat cancer, heart disease, inflammatory conditions, rare diseases, and obesity and obesity-related conditions. 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 Manager - Pittsburg, PA
What you will do
Let’s do this. Let’s change the world. In this vital role the Field Reimbursement Manager (FRM) 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 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).
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
Working Conditions:
3 days a week in geography for customer appointments (geography specific)
Preference to be located in southern Pittsburgh, PA
General office demands – Remote, Work from Home.
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.
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 OR
Master’s degree and 3 years of customer service and/or leadership experience OR
Bachelor’s degree and 5 years of customer service and/or leadership experience OR
Associate’s degree and 10 years of customer service and/or leadership experience OR
High school diploma / GED and 12 years of customer service and/or leadership experience
In addition to meeting at least one of the above requirements, you must have experience directly managing people and/or leadership experience leading teams, projects, programs, or directing the allocation or resources. Your managerial experience may run concurrently with the required technical experience referenced above
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
Live in the geography or less than 10 miles from the geography border
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 $145,471.00 to $196,813.00. 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 where possible. Refer to the Work Location Type in the job posting to see if this applies.
Apply now and make a lasting impact with the Amgen team.
careers.amgen.com
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Application deadline
Amgen does not have an application deadline for this position; we will continue accepting applications until we receive a sufficient number or select a candidate for the position.
Sponsorship
Sponsorship for this role is not guaranteed.
As an organization dedicated to improving the quality of life for people around the world, Amgen fosters an inclusive environment of diverse, ethical, committed and highly accomplished people who respect each other and live the Amgen values to continue advancing science to serve patients. Together, we compete in the fight against serious disease.
Amgen is an Equal Opportunity employer and will consider all qualified applicants for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability status, or any other basis protected by applicable law.
We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. Please contact us to request accommodation.
.Salary Range
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