Job Details

Urgent January Start Date

Field Reimbursement Manager. FRM San Francisco, CA

Expert in Retail Pharmacy and Specialty pharmacy drug Prior Authorizations, Appeals, and working denials, with experience of FRM territory management experience, training and educating provider office staff.

FIELD / TRAVEL position covering a territory: San Francisco, CA

The best FRM candidates will :

• Bring FRM territory experience (including experience working without access to PHI)
• Truly care about the patients and work through all roadblocks and barriers to get the medications approved and paid for.
• Have expertise in : RETAIL Pharmacy, as well as, Specialty Drug Prior authorizations through portals, benefits investigations , working appeals and denials
• Have LOCAL PAYOR LANDSCAPE KNOWLEDGE: Medicare & Medicaid
• Know some work arounds when PHI is not accessible
• Have experience in: escalations, education, Commercial co-pay card approvals , Patient Assistance program approvals , foundation coverage, guidelines, and reimbursement. Keeping up with changes and updates to drug programs, new FDA indications, miscellaneous J-codes, and payer policy changes that impact reimbursement.
• BA degree highly preferred

Urgent Start Date