Field Reimbursement Manager

This is what you will do: 

The Field Reimbursement Manager (RareNeurology,Hematology,& Nephrology) is a field-based, non-promotional role responsible for helping minimize barriers to patient access for our rare disease portfolio. You will act as the local subject matter expert on reimbursement, billing, coding, and patient support programs for assigned indications and therapies. By educating healthcare provider (HCP) offices, billing staff, and financial coordinators, you will help navigate complex coverage landscapes to ensure eligible patients receive timely access to therapy. This role reports directly to the Regional Field Reimbursement Director.

You will be responsible for: 

• Partnering with Alexion cross-functional partners on overall account and territory planning and strategy to maximize internal/external customer knowledge on payer policy and processes as well as routine documentation and presentation of plans.

• Being a subject matter expert on reimbursement and regional-specific access landscape. This includes medical/pharmacy benefit design, product acquisition, payer policies and coverage criteria, prior authorization requirements, denials, appeals, peer to peer and other education required to navigate access for coverage of assigned Alexion indications and therapies while operating in full alignment with company policy, legal requirements,and compliance standards.

• Develop and execute strategic account and territory plans that increase customer knowledge of reimbursement and access processes, using available resources, internal data,and field insights toprioritize activity and guide call objectives.

• Collaborating with Alexion OneSource Patient Services on individual case management needs related to HCP education on reimbursement issues.

• Identify, document, and communicatefield insights relatedto payer policy shifts, access barriers, denial trends, operational challenges, and customer education needs to help inform internal planning and decision-making.

• Collaborating with cross-functional partners to share insights and coordinate/ plan activities; attending internal regularly (with market access, patient services, medical, sales, compliance, legal, and other relevant partners, as appropriate) and company meetings as requested. 

• Maintain accurate documentation and operational reporting related to customer interactions, account plans, HCP office education, and case-relatedactivity inCRM andother approved systems, while managing work in alignment with annual priorities, key performance indicators, territory objectives, project priorities, and approved budget parameters

• Complying with all laws, regulations and policies that govern the conduct of Alexion activities; works with the highest degree of professionalism and in accordance with the company’s code of Ethics and Business Conduct.

You will need to have:

• Bachelor’s degree

• 5-7yearsexperiencein the healthcare and/or pharmaceutical/biotech industry

• 3+yearsexperienceworking with buy and bill and/or specialty pharmacy networks

• 3+ years of field reimbursement experience

• Understanding of access process from medical and pharmacy benefit design, Rx to infusion/injection 

• Experience with products that require prior authorization and clear understanding of related billing, coding and in-office support 

• Demonstrate adaptability to changing direction as conditions shift, learning mindset, taking ownership and driving actions 

• Excellent verbal, written, interpersonal communication and presentation skills 

• Ability to effectively communicate with people at all levels, inside and outside of the company

• Ability to educate physicians and other healthcare professionals with confidence and expertise in an office procedural environment

• Demonstrated strong cross-functional collaboration skills, business planning, rapport building and active listening skills

• Problem solver with a sense of urgency

• Experience working through complex reimbursement issues

• Experience working with billing and medical claim personnel in healthcare setting

• Experience working with integrated health systems

• Demonstrated technical aptitude and working proficiency in using iPad and Laptop and working proficiency in Microsoft Word, Excel, PowerPoint, and Outlook; willingness to travel with equipment to coordinate daily with key partners on education and case work.

• The duties of this role are generally conducted in a field environment.  As is typical of a field-based role, employees must be able, with or without an accommodation to: travel by public transportation, automobile, train, or plane; work comfortably in a clinical setting; use a computer; engage in communications via phone, video, and electronic messaging; problem solve; engage in complex and non-linear thought, analysis, and dialogue; collaborate with others; maintain general availability during standard business hours; operational reporting while traveling   

Travel and Role Related Areas

• Ability to travel to work related meetings and functions and ability to travel overnight for up to 4nights per week

• Ability to travel 60-75%

• Ability to drive to assigned targets within the territory with Company provided Fleet Electric Vehicle 

• A valid driver's license and clean driving record

• Ability to travel regionally and cover large multi-state territories

• Must reside in the assigned territory; relocation assistance is not provided

We wouldprefer foryou to have:

• Rare disease experience

• Understanding of the top regional and national payers within the assigned geography

• Experience in launching a new specialty pharmaceutical/biologic product or new product indication 

• Neurology, Hematologyand/orNephrology experience 

• Experience working through complex reimbursement issues

• Experience working with billing and medical claim personnel in healthcare setting

• PACS (Prior Authorization Certification Specialist) 

• Familiarity with applying AI tools and techniques to enhance efficiency

Travel and Role Related Areas

• Reside within Texas