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Field Reimbursement Manager – Botox Therapeutic
AbbVie. Educate healthcare providers and accounts on Medical and Pharmacy benefits, Buy & Bill, Specialty Pharmacy acquisition, payer policy, patient identification, clinical documentation, benefit investigations, prior authorizations, billing, coding, patient tracking, claim submission, reconciliation, savings programs, retreatment, and denial/appeal processes for approved BOTOX Therapeutics indications .
Core Competencies
Role fitUse this summary to align your resume positioning with the role.
Demonstrates expertise in educating healthcare providers on Medical and Pharmacy benefits, reimbursement processes, and patient access solutions. Proven ability to collaborate across functions and lead initiatives that enhance patient outcomes and streamline operations.
ATS Keywords
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About the role
Key responsibilities & impact- Educate healthcare providers and accounts on Medical and Pharmacy benefits, Buy & Bill, Specialty Pharmacy acquisition, payer policy, patient identification, clinical documentation, benefit investigations, prior authorizations, billing, coding, patient tracking, claim submission, reconciliation, savings programs, retreatment, and denial/appeal processes for approved BOTOX Therapeutics indications
- Clarify barriers that may delay appropriate treatment or prevent optimal patient outcomes
- Educate accounts on the BOTOX treatment process, reimbursement, payer landscape, HUB services, patient savings programs, coverage details, and acquisition initiatives
- Identify root causes of access and reimbursement issues and provide actionable, customized solutions
- Monitor and provide updates on regional and national payers, including medical policy, prior authorization requirements, and product acquisition changes
- Collaborate with Market Access, Center of Excellence, Sales, Marketing, Training, Compliance, Trade, and Specialty Pharmacy teams
- Provide customer feedback on approval requirements and access-to-care barriers
- Establish respectful relationships with healthcare professionals, staff, business decision-makers, and C-suite executives
- Lead without authority, influence across functions, gain consensus, and deliver crucial conversations professionally
- Participate in Field Input Teams and suggest innovative solutions to customer challenges
- Plan, prioritize, follow up, anticipate problems, and comply with AbbVie and regulatory requirements
Requirements
What you’ll need- A minimum of 5–7 years of proven success in a health care related field
- Bachelor’s degree required
- Knowledge of Lean Six Sigma principles is favorable
- Exposure to physician-administered injectables, CPT and/or J-code reimbursement, Specialty Pharmacy and Buy & Bill acquisition, Benefit Verifications, Prior Authorizations, Claim Assistance, Appeals, payor policies, and HUB services
- Proven record of comprehensive work with accounts at all levels
- Payer/insurance coverage experience with Medicare, Medicare Advantage, Commercial, and Medicaid plans
- Well-developed verbal and written communication skills, including in-person and virtual presentation skills for complex information and processes
- Competence in Problem Solving, Gain Access, Resource Mastery, Tangible Results, Overcoming Adversity, Collaboration, and Managing Complexities
- Empathy, Critical Thinking, Curiosity, Persistence, Reliability, and Resourcefulness
- Strong history of leadership within current role
- Technology and analytical skills, including Salesforce, virtual meetings, Excel, and report interpretation
- A valid driver’s license
- Ability to travel adequately to cover territory, attend training, and meetings; some overnight travel may be required
- Ability to live within a reasonable distance from the primary city
- This geography covers Minnesota and North Dakota
Benefits
Comp & perks- Paid time off (vacation, holidays, sick)
- Medical, dental, and vision insurance
- 401(k)
- Long-term incentive programs
- Bonus, commission, incentive, and other compensation may be available at the Company's discretion