Field Reimbursement Manager

Summary

Join Harrow, a leading North American ophthalmic-focused pharmaceutical company, as a Field Reimbursement Manager (Sr. FRM). 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. You will provide product-specific provider reimbursement education and support related to coverage, coding, and payment, and assist with patient-level reimbursement issues. This role requires managing an assigned geography, providing reimbursement assistance, and educating providers on Harrow’s products and services. You will collaborate with various internal stakeholders to achieve business objectives and maintain strong relationships with healthcare providers. The position is remote with 3-4 days of field work required.

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