Field Reimbursement Manager

Summary

Join Harrow, a leading North American ophthalmic-focused pharmaceutical company, as a Sr. Field Reimbursement Manager. Reporting to the Director- Provider and Patient Support, you will work with healthcare provider accounts and facilities to support access for Harrow’s ocular buy-and-bill products. Responsibilities include providing product-specific provider reimbursement education and support, assisting with patient-level reimbursement issues, and working with key stakeholders to achieve business objectives. This remote position requires 3-4 days of field work per week. The ideal candidate will have 8+ years of experience in healthcare reimbursement, brand management, or sales, a Bachelor's degree, and buy-and-bill experience. Additional preferred qualifications include healthcare credentialing/certification, Retina/Eye care experience, and knowledge of HCPCS Level II (J-code) and Transitional Pass-Through reimbursement.

Requirements

• 8+ years of combined proven success in a healthcare-related field reimbursement, brand management and/or sales experience
• Bachelor's degree
• Buy-and-Bill experience required
• Minimum 4+ years Field Reimbursement experience required
• Experience with benefit verifications, prior authorizations, claim assistance, and appeals required
• Payer coverage experience with Medicare (MACs), Medicare Advantage, Commercial, and Medicaid plans required

Responsibilities

• Responsible for managing an assigned geography and providing product reimbursement assistance and approved support tools and resources to healthcare providers in physician practices and facilities
• Provide in-person and/or virtual support to educate and train provider accounts and facilities on coverage, coding, and reimbursement of Harrow’s buy-and-bill-products, as well as Harrow Cares Patient Support Services HUB
• Assists healthcare providers and staff work through reimbursement barriers and understand the payer landscape
• Working knowledge of buy-and-bill and medical benefit reimbursement, as well as a clear understanding of Medicare, Medicare Advantage, Commercial, and Medicaid insurance plans and benefit design and coverage policies
• Works effectively and cross-functionally with multiple key stakeholders (sales, marketing, managed markets, compliance, legal, and regulatory) in a matrixed environment to achieve business objectives and key performance indicators (KPIs)
• Subject matter expert on reimbursement processes (i.e., benefit verification, prior authorization, claim assistance, and appeals) and knowledgeable of current Retina/Ophthalmology/Ocular market dynamics
• Builds and maintains strong relationships with HCP office; physicians, C-Suite leadership, practice administrators and integral operational staff
• Conducts all work activities in compliance with all internal requirements and meets all applicable business, compliance, legal, and regulatory requirements

Preferred Qualifications

• Healthcare credentialing and/or certification preferred
• Minimum 6+ years Retina/Eye care experience preferred
• Private Equity and/or Strategic account experience preferred
• HCPCS Level II (J-code) and Transitional Pass-Through reimbursement preferred

Benefits

• Remote
• 3-4 days field work required