Job Details

Job Description:

As a privately-owned, biopharmaceutical company, Ferring pioneers and delivers life-changing therapies that help people build families and live better lives. Our independence helps us cultivate an entrepreneurial spirit and long-term perspective that enables us to achieve growth and scale, while remaining agile and true to our ‘people first' philosophy. Built on a 70-year plus commitment to science and research, Ferring is relentless in its pursuit of science that drives powerful discoveries and therapies to help people build families, stay healthy, and stand up to the world's oldest enemy: disease.

The Field Reimbursement Manager (FRM) will play a critical role in supporting the management of defined accounts in a specified geographic region for the Microbiome therapeutic area to deliver exceptional customer experience and with the potential to expand to other products over time. The FRM will execute the collaborative territory strategic plan through partnership with internal and external stakeholders, including acting as an extension of the patient support program and in other coordination with other partners. This role will be focused on ensuring understanding of access and reimbursement specifically, as it relates to a rare disease product. The FRM will lead with supporting resolution on patient-specific cases to address reimbursement, coding, prior authorization process, appeals while compliantly handling of patient health information (PHI).

Responsibilities:

• Serve as a key front-line team player providing in-person and virtual support for in-services and to address questions related to access and reimbursement, guiding the patient access journey from prescriber decision to claim reimbursement.
• Possess in-depth knowledge of payer systems, reimbursement processes, and healthcare regulations (e.g., CMS, Medicaid, commercial payers), coding and billing requirements for multiple sites of care and educate stakeholders on relevant information.
• Educate healthcare provider (HCP) office staff on prior authorization requirements, coverage status, payer appeal requirements, and applicable processes and timelines.
• Review clinical information in patient charts, interpret payer policies, and support HCP offices in completing prior authorization, formulary exception, and appeals documentation to resolve escalations or coverage challenges.
• Coordinate with other patient support program representatives and the field sales team as needed.
• Educate physician office staff on patient access programs and available service offerings.
• Serve as the payer expert for the designated geography, communicating any changes to key stakeholders in a timely manner.
• Collaborate with cross-functional teams and external partners to develop and implement local access strategies, address customer needs, and continuously improve patient access and the overall customer experience.

Requirements:

• Bachelor's degree required; advanced degree or specific practice management experience preferred.
• 8+ years of industry experience in reimbursement, patient access, or market access.
• 3+ years of experience in an FRM role supporting Buy and Bill reimbursement.
• In-depth knowledge of healthcare reimbursement systems, coding, and billing practices required.
• Ability to travel up to 65% and possess a valid driver's license.

Location: Parsippany, New Jersey