Cesna Recruitment

Director, Field Reimbursement (National)

Full-time · Remote
✓ Verified live on the employer's own system · added 147 days ago
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Mid-level · 5+ yrs exp

Requirements

Education: Bachelor's degree

Experience: 5+ years

Skills & tools

ManagementTeam LeadershipPatient CareRecordkeeping

Benefits — mentioned in this posting

Health, dental & vision
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Full job description

Field Reimbursement Director reports to the VP of Access Operation.

The Field Reimbursement Director will oversee and manage a team of Field Reimbursement Managers (FRM) across assigned territories, ensuring that all aspects of reimbursement strategies are executed effectively to maximize product access and coverage.

The Director will act as a key leader responsible for the coordination of field-based reimbursement efforts, offering strategic direction, support, and leadership to ensure the team is successful in navigating payer landscapes, insurance policies, and reimbursement processes.

- Leading and managing the FRM team to ensure proper execution of reimbursement strategies, ensuring patient access to products across all geographies.

- Developing and implementing reimbursement strategies to guarantee appropriate coverage and access for company products.

- Working closely with healthcare providers, payers, and patients to ensure the products are covered by insurance plans.

- Reviewing and approving complex reimbursement cases and assisting FRM team members in resolving coverage challenges and issues.

- Monitoring payer policy changes, ensuring alignment with product reimbursement strategies and working with internal teams to address any potential barriers.

- Analyzing payer trends, identifying areas for improvement, and adjusting strategies to ensure the continued success of reimbursement efforts.

- Collaborating with external teams to identify and implement funding or financial assistance programs that support patient access to treatments.

- Supporting the team in handling prior authorizations, appeals, and denials, and ensuring all necessary documentation is submitted in a timely and compliant manner.

- Reviewing patient-specific cases, identifying challenges, and recommending solutions in collaboration with healthcare providers and internal teams.

- Conducting both quantitative and qualitative analysis of FRM team activities and providing detailed reports to VP of Access Operation.

- Based on progress analysis, identifying and implementing improvements to optimize the team's performance and enhance the overall reimbursement process.

- Bachelor's degree in business, healthcare, or related field.

- Minimum of 10 years of experience in pharmaceutical reimbursement, managed care, or related field, with at least 5 years of experience in a leadership role.

- Strong knowledge of healthcare reimbursement policies and procedures.

- Ability to develop and implement reimbursement strategies.

- Strong analytical skills and ability to analyze data and trends.

- Ability to lead and manage a team and work collaboratively with cross-functional stakeholders.

- Full

Benefits - Medical, Dental, Vision with different package

- Bachelor's degree in business, healthcare, or related field.

- Minimum of 10 years of experience in pharmaceutical reimbursement, managed care, or related field, with at least 5 years of experience in a leadership role.

- Strong knowledge of healthcare reimbursement policies and procedures.

- Ability to develop and implement reimbursement strategies.

- Strong analytical skills and ability to analyze data and trends.

- Ability to lead and manage a team and work collaboratively with cross-functional stakeholders.

Field Reimbursement Director reports to the VP of Access Operation.

The Field Reimbursement Director will oversee and manage a team of Field Reimbursement Managers (FRM) across assigned territories, ensuring that all aspects of reimbursement strategies are executed effectively to maximize product access and coverage.

The Director will act as a key leader responsible for the coordination of field-based reimbursement efforts, offering strategic direction, support, and leadership to ensure the team is successful in navigating payer landscapes, insurance policies, and reimbursement processes.

- Leading and managing the FRM team to ensure proper execution of reimbursement strategies, ensuring patient access to products across all geographies.

- Developing and implementing reimbursement strategies to guarantee appropriate coverage and access for company products.

- Working closely with healthcare providers, payers, and patients to ensure the products are covered by insurance plans.

- Reviewing and approving complex reimbursement cases and assisting FRM team members in resolving coverage challenges and issues.

- Monitoring payer policy changes, ensuring alignment with product reimbursement strategies and working with internal teams to address any potential barriers.

- Analyzing payer trends, identifying areas for improvement, and adjusting strategies to ensure the continued success of reimbursement efforts.

- Collaborating with external teams to identify and implement funding or financial assistance programs that support patient access to treatments.

- Supporting the team in handling prior authorizations, appeals, and denials, and ensuring all necessary documentation is submitted in a timely and compliant manner.

- Reviewing patient-specific cases, identifying challenges, and recommending solutions in collaboration with healthcare providers and internal teams.

- Conducting both quantitative and qualitative analysis of FRM team activities and providing detailed reports to VP of Access Operation.

- Based on progress analysis, identifying and implementing improvements to optimize the team's performance and enhance the overall reimbursement process.

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This posting was published by Cesna Recruitment on their own careers system and is shown here with a direct link to apply there. Employers: for corrections or removal, contact jobs@veritahire.com.