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Field Reimbursement Manager – Botox Therapeutic
AbbVie. Educate healthcare providers and staff on Medical and Pharmacy benefits, Buy & Bill and Specialty Pharmacy acquisition, payer policy, patient identification, clinical documentation, benefit investigations, prior authorizations, billing, coding, patient tracking, claims, 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 analyze barriers and implement actionable strategies while maintaining compliance with regulatory requirements.
ATS Keywords
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About the role
Key responsibilities & impact- Educate healthcare providers and staff on Medical and Pharmacy benefits, Buy & Bill and Specialty Pharmacy acquisition, payer policy, patient identification, clinical documentation, benefit investigations, prior authorizations, billing, coding, patient tracking, claims, reconciliation, savings programs, retreatment, and denial/appeal processes for approved BOTOX Therapeutics indications
- Clarify barriers that delay or prevent appropriate patient access and optimal outcomes
- Interact with healthcare providers, administrative staff, revenue cycle management, and institutional leadership
- 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 issues and provide analytical, customized, actionable solutions
- Monitor and update stakeholders on regional and national payer changes and barriers
- Exchange critical information using compliant methods
- Liaise among Market Access, Center of Excellence, Sales, Marketing, Training, Compliance, Trade, and Specialty Pharmacy teams
- Provide customer feedback on approval requirements and access barriers
- Establish and maintain relationships with healthcare professionals, staff, and C-suite decision makers
- Lead without authority, influence across functions, facilitate consensus, and conduct crucial conversations
- Participate in Field Input Teams and propose solutions to customer challenges
- Plan, prioritize, follow up, anticipate problems, and comply with AbbVie and regulatory requirements
Requirements
What you’ll need- 5–7 years of proven success in a health care related field
- Bachelor’s degree required
- Preferred experience in Sales, District Management, Hospital, Managed Markets, Access and Reimbursement, or practice settings
- Knowledge of Lean Six Sigma principles favorable
- Experience with 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
- Experience working with accounts at all levels
- Payer/insurance coverage experience with Medicare, Medicare Advantage, Commercial, and Medicaid plans
- Strong verbal and written communication, including in-person and virtual presentation skills
- Competence in problem solving, gaining access, resource mastery, tangible results, overcoming adversity, collaboration, and managing complexities
- Empathy, critical thinking, curiosity, persistence, reliability, and resourcefulness
- Strong leadership history
- Technology and analytical skills, including Salesforce, virtual meetings, Excel, and report interpretation
- Ability to drive a personal auto, company car or truck, or powered material-handling equipment
- Valid driver’s license
- Ability to pass a pre-employment drug screening test and meet safe driving requirements
- Ability to travel adequately to cover territory, attend training, and meetings; some overnight travel may be required
Benefits
Comp & perks- Paid time off (vacation, holidays, sick)
- Medical, dental, and vision insurance
- 401(k)
- Long-term incentive programs
- Remote work option
- Travel and training opportunities