Position Description

The Field Reimbursement Territory Manager (FRTM) 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 both remote interaction and on-site training. This position is client-facing and customer-facing and requires the ability to build relationships with physician offices as well as manufacturer representatives to effectively deliver services based on customer specific preferences. The FRTM works independently in a fast paced, highly visible environment as well as collaboratively with the internal program hub support services to ensure all customer needs are met. The FRTM will frequently interact via telephone with providers and internal staff to arrange site visits, Manufacturer trainings, and educational training venues. Must have a solid working knowledge of Medicare and Commercial insurance plans and benefit structures in order to relay detailed benefit information and maximize the customer experience. Position will require extensive travel, project management and/or account coordination.

Key Responsibilities

Provide on-site and on-demand education (including Lunch and Learns or Dinner presentations) for the office staff in regards to reimbursement challenges and support services that are available.

Office interaction will include:

Educate:

  • Benefit Investigation / Prior Authorization Process
  • Support Center Services
  • Medicare and Commercial coverage
  • Educate on the patient communication streams

Reimbursement Support:

  • Case management
  • Billing and coding updates
  • Appropriate claims submission
  • Specialty Pharmacy
  • Medical Benefit Interpretation
  • Understanding medical necessity
  • Claims / Appeal assistance
  • Information related to co-pay assistance programs
  • Information related to patient assistance programs
  • Responsible for setting up appointments and completing out bound calls to targeted offices
  • Assist in completing backlog casework
  • Additional day-to-day in-office work
  • Interface with physicians and manufacturer representatives to obtain and provide patient and provider specific information
  • Monitor program performance for physicians and manufacturer representatives in accordance with expectations
  • Research and compile provider / manufacturer representative specific information for reimbursement database. (Includes account profiles)
  • Utilize internal resources to proactively address areas of opportunity related to the overall customer experience
  • Utilize performance tracking tools & survey

Minimum Requirements

  • Entry-level experience in project management
  • This position will be supporting a specific territory. The desired applicant will already need to reside near a major airport within the desired city of that territory.

Critical Skills

  • Strong medical reimbursement experience with Buy & Bill and/or Specialty Pharmacy.
  • Experience in the healthcare industry including, but not limited to insurance verification, prior authorizations, and/or claim adjudication, physician’s office or clinics.
  • Must have Medicare and commercial insurance coverage experience.
  • Must be able to deliver and document benefit investigation outcomes and relay status reports on a regular basis.
  • Strong customer service experience
  • Proven presentation skills and experience
  • Ability to effectively handle multiple priorities within a changing environment
  • Excellent organizational skills
  • Strong Computer literacy including PowerPoint and Web Meeting experience
  • Must have a valid driver's license with a clean driving record/ MVR

Additional Knowledge & Skills

  • Previous field experience, a plus
  • Previous experience with specialty pharmacy a plus
  • Account management and project management experience, a plus
  • Excellent Interpersonal skills.
  • Excellent written and oral communication skills
  • Problem solving and decision making skills

Education

Bachelor’s Degree required; degree in Business or Healthcare related field preferred or a minimum of 8 years healthcare related reimbursement experience

Travel Requirements

  • Must be able to travel 80% (4 days a week) via automobile or plane
  • Must have a valid driver's license with a clean driving record/ MVR

Physical Requirements

General Office Demands

Career Level: P3

McKesson is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, creed, sex, sexual orientation, gender identity, national origin, disability, or protected Veteran status.Qualified applicants will not be disqualified from consideration for employment based upon criminal history.McKesson is committed to being an Equal Employment Opportunity Employer and offers opportunities to all job seekers including job seekers with disabilities. If you need a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to Disability_Accommodation@McKesson.com. Resumes or CVs submitted to this email box will not be accepted.Current employees must apply through internal career site.Join us at McKesson!


13 days ago - source