Act as a compliant subject matter expert (SME) in reimbursement, access, and specialty distribution for assigned geography.
Provide education to HCP offices on coverage status, prior authorization processes, appeals, and alternate funding options for uninsured/underinsured patients.
Build and maintain productive relationships with HCPs, office staff, and health system stakeholders.
Analyze regional and local payer coverage trends, reimbursement criteria, and payer mix.
Provide guidance on specialty pharmacy services and help customers navigate complex distribution channels.
Partner with the Patient Support team to ensure accurate benefit investigations and streamlined patient onboarding.
Collaborate with internal partners to build local access strategies aligned with business objectives.
Develop and execute territory-level business plans using strategic customer insights.
Participate in field-based problem-solving, including reimbursement issue resolution and case escalation when needed.
Identify process improvements and innovations to enhance patient access and provider satisfaction.
Maintain compliance with legal, regulatory, and company policies, especially those governing patient privacy and promotional conduct.

Bachelor’s degree in an allied health field preferred or equivalent work experience.
8+ years of experience in the pharmaceutical, biotech, or related healthcare industry.
Previous Reimbursement Experience Required: Candidates should have substantial experience with prior authorizations and navigating the US payer landscape.
3–6 years of experience supporting Specialty Pharmaceuticals/Biologics.
Deep understanding of reimbursement, access, and specialty pharmacy operations.
Experience supporting product launches or guiding patients through insurance approval processes.
Strong understanding of Specialty Pharmacy distribution models and patient services programs.
Knowledge of HIPAA and other federal/state laws governing patient confidentiality and healthcare communications.
Bilingual skills are highly desired (English/Spanish).
Proven track record supporting complex therapies in rare or specialty conditions
Exceptional communication and interpersonal skills with the ability to build trust with providers, and internal partners.
Comfort navigating ambiguity, managing multiple cases simultaneously, and solving problems in real time.
Digital fluency with CRM platforms and comfort educating patients on technology-enabled support tools, including AI-based platforms.

Field Reimbursement Manager, Southern California

Key skills