Field Reimbursement Manager

As Field Reimbursement Manager, your responsibilities will include:  

Provider & Account Support 

• Serve as the primary field-based reimbursement resource for oncology and rare disease providers, infusion centers, hospitals, and specialty pharmacies 

• Educate healthcare providers and staff on payer coverage, prior authorization requirements, site-of-care considerations, and reimbursement pathways 

• Provide guidance on coding, billing, claims submission, and appeals processes for buy-and-bill and specialty pharmacy-distributed products 

• Assist accounts in navigating complex payer policies, including Medicare, Medicaid, and commercial payers 

Patient Access & Support 

• Support access to company-sponsored patient assistance, and co-pay programs in compliance with regulatory and legal guidelines 

• Collaborate with patient services hubs and specialty pharmacies to resolve complex access or reimbursement challenges 

• Identify and escalate systemic access issues and payer trends impacting patient access 

Internal Collaboration & Strategy 

• Partner with Sales, Market Access, and Medical Affairs to support account-specific access strategies without promotional influence 

• Provide field insights related to payer policies, coverage trends, and reimbursement barriers 

• Support product launches, formulary initiatives, and access pull-through strategies 

Compliance & Education 

• Ensure all activities are compliant with company policies, OIG guidance, FDA regulations, and industry standards 

• Deliver compliant reimbursement education without engaging in promotional activities 

• Maintain accurate documentation of field activities and customer interactions 

Data, Reporting & Continuous Improvement 

• Track and report reimbursement issues, payer trends, and case outcomes 

• Utilize CRM and case management systems to document activities 

• Participate in ongoing training to remain current on reimbursement, policy, and oncology/rare disease treatment landscapes 

The above duties and responsibilities are not an exhaustive list, and you may be required to undertake any other reasonable duties compatible with your experience and competencies. This description may be varied from time to time to reflect changing business requirements.  

To be successful in this role, you should demonstrate:  

• Bachelor’s degree (Healthcare, Business, Life Sciences, or related field preferred) MBA preferred. 

• Minimum 5+ years of experience in reimbursement, market access, patient services 

• Experience supporting oncology and/or rare disease therapies 

• Strong knowledge of payer landscapes including Medicare, Medicaid, and commercial plans 

• Familiarity with buy-and-bill, specialty pharmacy distribution models, and site-of-care reimbursement 

• Ability to travel extensively within assigned territory (70%) 

• Experience in field-based reimbursement or access roles required  

• Knowledge of oncology coding (J-codes, HCPCS, ICD-10, CPT) preferred 

• Experience with hospital reimbursement pathways including outlier payment & NTAP. 

• Experience working with patient support hubs and specialty pharmacies preferred 

• Advanced understanding of rare disease access challenges preferred  

Core Competencies: 

• Deep understanding of reimbursement and payer policy complexity 

• Strong communication and education skills 

• Collaborative, cross-functional mindset 

• Analytical problem-solving abilities 

• High integrity and compliance-focused approach 

Company Benefits 

• Hybrid Working 

• Auto Allowance 

• Vacation, Personal and Sick time 

• 15 Paid Company Holidays 

• Medical, Dental, Vision and other Voluntary benefits 

• Paid Parental Leave 

• Tuition Assistance 

• Discretionary Bonus Plan 

• Competitive 401(k), $1 for $1 up to 6% of pay. The safe harbour match is vested immediately. In addition, SERB also offers a discretionary match of up to 4% of pay which vests 20% a year for 5 years.