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Director, Field Reimbursement (National)

1 month, 2 weeks ago
United States
Full-time
Lead
Operations Manager
Operations
Apply Now
Cesna Recruitment Group

Cesna Recruitment Group

Cesna Recruitment Group is a global leading talent recruitment services company, specializing in senior and middle manager level searches across various industries. With a presence in Asia Pacific, China, Europe, and America, Cesna has helped over 4,00...

Professional Services
51-250
Founded 1999
View All Jobs 11

Description

  • Lead and manage a team of Field Reimbursement Managers across assigned territories.
  • Develop and implement reimbursement strategies to maximize product access and coverage.
  • Work with healthcare providers, payers, and patients to resolve insurance coverage and reimbursement issues.
  • Review and approve complex reimbursement cases and support FRM team members with escalations.
  • Monitor payer policy changes and adjust reimbursement strategies to address access barriers.
  • Analyze payer trends and FRM team performance, then recommend improvements to reimbursement processes.
  • Collaborate with internal and external teams to identify funding or financial assistance programs.
  • Support prior authorizations, appeals, and denials, ensuring documentation is timely and compliant.
  • Review patient-specific cases and recommend solutions in partnership with providers and internal stakeholders.
  • Prepare quantitative and qualitative performance reports for the VP of Access Operation.

Requirements

  • Bachelor's degree in business, healthcare, or a related field.
  • Minimum 10 years of experience in pharmaceutical reimbursement, managed care, or a related field.
  • At least 5 years of leadership experience.
  • Strong knowledge of healthcare reimbursement policies and procedures.
  • Experience developing and implementing reimbursement strategies.
  • Excellent communication and interpersonal skills.
  • Strong analytical skills with the ability to analyze data and trends.
  • Ability to lead teams and collaborate with cross-functional stakeholders.
  • Ability to work independently and in a team environment.
  • Willingness to travel as required.
  • Immunology and/or oncology experience preferred.

Benefits

  • Salary range of $200,000 to $240,000 plus bonus.
  • Full benefits package.
  • Medical, dental, and vision coverage with different plan options.
  • 401(k) with 4.5% match.
  • PTO plus 6 sick days.

Interested in this position?

Apply directly on the company website

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