Role SummaryThe Immunology Field Reimbursement Manager (FRM) is a field-based resource addressing health care professional questions about patient access and reimbursement for AbbVie Immunology products. The FRM visits HCP offices within a defined geography to educate on coverage, payer processes, and access options, and to advise on patient prescription status and program eligibility. The role involves providing local expertise on payor policies, coding, and claims submission, and maintaining relationships with providers in the territory.
Responsibilities
Educate HCPs on patient support programs, including access and reimbursement tools and services
Educate on product-specific acquisition and access options such as specialty pharmacy networks, specialty distribution, and white-bagging support
Educate on resources available to address access issues
Provide local expertise on national/regional payor policies to educate providers on payer issues, coding changes, and appropriate claims submission processes
Liaise with Abbvie's Access and Reimbursement support center to update HCPs on Rx status and program eligibility
Report back payer trends related to approved products to Patient Services and Market Access account management teams
Establish and maintain relationships with appropriate providers within territory
Remain current on key managed care, reimbursement, and policy activities
Qualifications
At least 3 years of experience in Immunology with experience in Managed Health Care, Payer Account Management, and/or Access and Reimbursement
Demonstrated understanding of the rules, regulations and risks associated with provision of reimbursement support services
Thorough understanding of the technical payer policy processes, systems and requirements for coverage, coding, and payment for specialty medicinesStrong understanding and ability to communicate technical elements of coding and billing requirements at the National and Regional level across all settings of care
Comprehensive understanding of Parts A, B, C and D or Medicare and associated reimbursement dynamics
Excellent territory and account management skills
Bachelor's degree
Valid driver's license and ability to pass a pre-employment drug screening; safe driving
Must satisfy all applicable health care industry representative (HCIR) credentialing requirements to gain and maintain entry into facilities and organizations within the assigned territory
HCIR credentialing may include background checks, drug screens, immunization proof, fingerprinting, and state/city licenses; candidate responsible for meeting requirements
Education
Bachelor's degree
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