Field Reimbursement Manager - East

The EVERSANA/Theratechnologies Field Reimbursement Manager (FRM) plays a critical role in minimizing access and reimbursement barriers for patients and healthcare providers to ensure timely access to the product portfolio. By addressing complex patient access challenges, the FRM serves as a trusted resource for private practices, multi-specialty groups, and facilities, supporting them throughout the reimbursement cycle. This role collaborates closely with Market Access, Patient Services, and Field Sales teams to ensure seamless patient drug accessibility and delivers compliant, patient-focused solutions to optimize access.

ESSENTIAL DUTIES AND RESPONSIBILITIES:
Our employees are tasked with delivering excellent business results through the efforts of their teams. These results are achieved by:

• Proactively address patient access barriers by working with customers and accounts to resolve complex reimbursement issues, including prior authorizations, appeals, and denials.
• Educate private practices, multi-specialty groups, facilities, and their staff on reimbursement support programs, coverage, coding, and payer policies.
• Partner with internal and external stakeholders to identify, anticipate, and address patient and practice reimbursement challenges.
• Collaborate cross-functionally with Market Access, Patient Services, and Field Sales to provide compliant support for patients’ access to therapy.
• Deliver clear and actionable information to practice managers, billing staff, nurses, and reimbursement teams to improve their understanding of payer policies and processes.
• Provide real-time communication on payer policy updates and system changes that impact patient access in assigned accounts.
• Conduct regular reviews with practices to understand their utilization of reimbursement support services and recommend program enhancements based on customer needs.
• Handle patient health information (PHI) in accordance with HIPAA guidelines and company compliance policies.
• Demonstrate a commitment to diversity, equity, and inclusion through continuous development, modeling inclusive behaviors, and proactively managing bias.
• Maintain a deep understanding of policies, industry trends, and the legal and compliance aspects of reimbursement, applying this knowledge to all responsibilities.
• Ensure a compliant relationship with state, local, and institutional societies while educating and supporting practices and accounts.
• Share insights into customer needs, potential access barriers, and payer trends with internal teams to drive actionable improvements.
• All other duties as assigned

MINIMUM KNOWLEDGE, SKILLS AND ABILITIES:

The requirements listed below are representative of the experience, education, knowledge, skill and/or abilities required.

• Education: Bachelor’s Degree
• Experience and/or Training:
• Proven experience in resolving complex patient access challenges, including prior authorizations, appeals, and denials.
• Strong knowledge of the US healthcare system, reimbursement policies, and patient assistance programs.
• Familiarity with the appropriate handling and use of PHI under HIPAA and other relevant legal frameworks.
• Expertise in sales, sales management, marketing, training, market access, or account management
• Demonstrated ability to collaborate cross-functionally and manage stakeholder relationships effectively.
• Ability to analyze customer insights and market dynamics to adapt strategies for patient access and support.
• Willingness to travel as needed for field activities, meetings, and conferences,
  including overnight travel (>75%)
• All other duties as assigned

Personal Qualities For All Staff

• Ability to set goals and deliver agreed objectives under tight timelines
• Ability to prioritize
• Ability to generate ideas and find solutions
• Ability to work both alone and in a team
• Team spirit and tendency to help each other
• Versatility and flexibility
• Exceptional organizational skills
• Ability to assemble and lead cross-functional teams toward a shared vision of success

OUR CULTURAL BELIEFS

Patient Minded I act with the patient’s best interest in mind.

Client Delight I own every client experience and its impact on results.

Take Action I am empowered and hold myself accountable.

Embrace Diversity I create an environment of awareness and respect.

Grow Talent I own my development and invest in the development of others.

Win Together I passionately connect with anyone, anywhere, anytime to achieve results.

Communication Matters I speak up to create transparent, thoughtful, and timely dialogue.

Always Innovate I am bold and creative in everything I do.

Our team is aware of recent fraudulent job offers in the market, misrepresenting EVERSANA. Recruitment fraud is a sophisticated scam commonly perpetrated through online services using fake websites, unsolicited e-mails, or even text messages claiming to be a legitimate company. Some of these scams request personal information and even payment for training or job application fees. Please know EVERSANA would never require personal information nor payment of any kind during the employment process. We respect the personal rights of all candidates looking to explore careers at EVERSANA.

EVERSANA is committed to providing competitive salaries and benefits for all employees. If this job posting includes a base salary range, it represents the low and high end of the salary range for this position and is not applicable to locations outside of the U.S. Compensation will be determined based on relevant experience, other job-related qualifications/skills, and geographic location (to account for comparative cost of living). More information about EVERSANA’s benefits package can be found at eversana.com/careers. EVERSANA reserves the right to modify this base salary range and benefits at any time.

From EVERSANA’s inception, Diversity, Equity & Inclusion have always been key to our success. We are an Equal Opportunity Employer, and our employees are people with different strengths, experiences, and backgrounds who share a passion for improving the lives of patients and leading innovation within the healthcare industry. Diversity not only includes race and gender identity, but also age, disability status, veteran status, sexual orientation, religion, and many other parts of one’s identity. All of our employees’ points of view are key to our success, and inclusion is everyone's responsibility.

Consistent with the Americans with Disabilities Act (ADA) and applicable state and local laws, it is the policy of EVERSANA to provide reasonable accommodation when requested by a qualified applicant or candidate with a disability, unless such accommodation would cause an undue hardship for EVERSANA. The policy regarding requests for reasonable accommodations applies to all aspects of the hiring process. If reasonable accommodation is needed to participate in the interview and hiring process, please contact us at applicantsupport@eversana.com.

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At EVERSANA, we are proud to be certified as a Great Place to Work across the globe. We’re fueled by our vision to create a healthier world. How? Our global team of more than 7,000 employees is committed to creating and delivering next-generation commercialization services to the life sciences industry. We are grounded in our cultural beliefs and serve more than 650 clients ranging from innovative biotech start-ups to established pharmaceutical companies. Our products, services and solutions help bring innovative therapies to market and support the patients who depend on them. Our jobs, skills and talents are unique, but together we make an impact every day. Join us!

Across our growing organization, we embrace diversity in backgrounds and experiences. Improving patient lives around the world is a priority, and we need people from all backgrounds and swaths of life to help build the future of the healthcare and the life sciences industry. We believe our people make all the difference in cultivating an inclusive culture that embraces our cultural beliefs. We are deliberate and self-reflective about the kind of team and culture we are building. We look for team members that are not only strong in their own aptitudes but also who care deeply about EVERSANA, our people, clients and most importantly, the patients we serve. We are EVERSANA.

Originally posted on Himalayas