Job Details

Overview

Join to apply for the Field Reimbursement Manager role at McKesson.

McKesson is an impact-driven company that touches virtually every aspect of healthcare. We focus on health, happiness, and well-being of patients and communities, and encourage growth and new ideas.

The Field Reimbursement Manager (FRM) is responsible for managing an assigned territory focused on supporting Reimbursement and Patient services by providing assistance with patient reimbursement challenges for a specific drug (including Benefit Investigation, Prior Authorization, Claims Assistance, and Appeals) and educating the office on payer landscape and services available through remote interaction and on-site training. This role is client-facing and requires building relationships with physician offices and manufacturer representatives to deliver services based on customer needs. FRM works independently in a fast-paced environment and collaborates with internal program hub support services to ensure all customer needs are met. FRM frequently interacts via telephone with providers and internal staff to arrange site visits, manufacturer trainings, and educational venues. A solid working knowledge of Medicare and Commercial insurance plans and benefit structures is required to relay detailed benefit information and maximize the customer experience. Travel, project management, and/or account coordination may be required based on client expectations.

Key Responsibilities

• Provide on-site and on-demand education (including Lunch and Learns or Dinner presentations) for office staff regarding Reimbursement challenges and available support services. On-site/virtual interactions average 15 per week and activities are recorded in FRM CRM with weekly reporting to manager.
• Educate on Benefit Investigation, Prior Authorization Process, Support Center Services, Medicare and Commercial coverage, and patient communication streams. Monthly activity reporting covers educational topics at FRM level reportable to client; trending data is reported quarterly.
• Provide reimbursement support on case management, billing and coding updates, appropriate claims submission, Specialty Pharmacy, Medical Benefit Interpretation, medical necessity, claims and appeal assistance, and information related to co-pay and patient assistance programs. Collaborate with the case manager on average 4/month for escalations; interactions tracked in FRM CRM and hub system.
• Set up appointments and complete outbound calls to targeted offices. Assist in backlog casework. Interface with physicians and manufacturer representatives to obtain and provide patient and provider information. All FRM interactions/activities are tracked in FRM CRM and reportable to management and client.
• Monitor program performance for physicians and manufacturer representatives. Territory performance monitored via FRM CRM dashboard daily; quarterly reporting identifies trends. Clients may survey customers on program performance.
• Research and compile provider/manufacturer representative information for reimbursement database (including account profiles). Create facility database on each new provider in FRM CRM; all interactions/activities rely on this database.

Minimum Job Qualifications

• 4-year degree in related field or equivalent experience
• 4+ years of healthcare related reimbursement experience

Business Experience

• Strong medical reimbursement experience with Buy & Bill and/or Specialty Pharmacy
• Experience supporting oncology products preferred
• Experience in the healthcare industry including insurance verification, prior authorizations, and/or claim adjudication; physician offices or clinics
• Must have Medicare and commercial insurance coverage experience
• Must be able to document benefit investigation outcomes and relay status reports regularly
• Proven presentation skills and experience
• Proven ability to handle multiple priorities with excellent organizational skills
• Strong computer literacy including PowerPoint and Web Meeting experience

Specialized Knowledge/Skills

• Previous field experience is a plus
• Previous experience with specialty pharmacy is a plus
• Account management experience is a plus
• Excellent interpersonal, written and oral communication skills
• Problem solving and decision-making skills

Travel Requirements

Must reside in territory. Must travel up to 80% (4 days a week) via automobile or plane. Must have a valid driver''s license with a clean driving record/MVR.

Physical Requirements

Possible long periods of sitting and/or keyboard work. General office demands.

Compensation and Benefits

Competitive compensation package as part of Total Rewards. Pay range is aligned with McKesson''s pay philosophy and may include annual bonus or long-term incentive opportunities. More information on benefits is available on the company site.

Equal Opportunity

McKesson is an Equal Opportunity Employer. We provide equal employment opportunities to applicants and employees regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, disability, age or genetic information. For details, see McKesson's Equal Employment Opportunity policies.

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