Field Reimbursement Manager - Botox Therapeutic
AbbVie
Field Reimbursement Manager - Botox Therapeutic
Job Description
The Reimbursement Business Advisor (RBA) shares expertise and educates on Medical and Pharmacy benefits, Buy & Bill and Specialty Pharmacy acquisition, payor policy, appropriate patient identification, clinical documentation, benefit investigation results, prior authorizations, billing, coding, patient tracking, claim submission, reconciliation management, patient financial savings programs, patient tracking/retreatment, and the denial/appeal process for the approved indications for BOTOX® Therapeutics. The RBA clarifies barriers that may impede or delay appropriate patient access to treatment and/or prevent optimal patient outcomes. The RBA may interact with healthcare providers, administrative staff, revenue cycle management, and institutional leadership.After the patient has been identified by an ABS provider, the RBA offers approved tools and standardization methods to provide reimbursement and technical knowledge to gain patient access while reducing access challenges.Educate on the fundamentals of the BOTOX treatment process, appropriate reimbursement, and understanding the payer landscapeLeverages advance problem-solving and analytical skills to identify access and reimbursement barriers while offering actionable insights to desired and approved careUncover the root cause to access issues impeding or delaying proper treatmentMonitor and provide updates on both Region and National Payers. Examples include changes or barriers in medical policy, Prior Authorization requirements, or product acquisition. Apply compliant methods to exchange critical informationWork collaboratively and function as a liaison for information between various internal stakeholders such as: Market Access, Center of Excellence, Sales, Marketing, Training, Compliance, Trade, and Specialty Pharmacy groups.Provide customer feedback relating to approval requirements and access to care barriers with AbbVie stakeholders (Market Access, Center of Excellence, Sales, Marketing, Trade, Specialty Pharmacy, Senior Leadership) Educate accounts on need-based tools to support patient access. Examples include HUB services, patient savings programs, payer coverage details, and acquisition pull-through initiativesProficient in providing analytical and customized need-based solutions to problems in complex environments and matrix influenced health systems and practicesEstablish and maintain respectful working relationships with healthcare professionals and staff as well as business-oriented decision makers including C-Suite level executives within territoryDemonstrates the ability to lead without authority and effectively communicate with diverse groups with sometimes different prioritiesCapable of influencing across functions to gain consensus on agreed upon patient solutionsAbility to professionally deliver crucial conversations that may contain less than desirable information or factsProactively engage in Field Input Teams offering innovative solutions to problems in a fast-paced changing environmentShare customer challenges and suggest potential solutions to address obstaclesDemonstrate effective planning, prioritization, follow up, and anticipates problemsThe employee conducts all work activities in compliance with all AbbVie internal requirements and with all applicable regulatory requirements
Locations
- Detroit, MI
Salary
106,500 - 202,500 USD / yearly
Estimated Salary Rangemedium confidence
100,000 - 150,000 USD / yearly
Source: AI estimated from job description
* This is an estimated range based on market data and may vary based on experience and qualifications.
Skills Required
- Expertise in reimbursement processes including medical and pharmacy benefits, buy & bill, specialty pharmacy acquisition, payor policy, prior authorizations, billing, coding, claim submission, and denial/appeal processesintermediate
- Advanced problem-solving and analytical skillsintermediate
- Knowledge of payer landscape and monitoring changes in medical policy and prior authorization requirementsintermediate
- Collaborative liaison skills across internal stakeholdersintermediate
- Effective communication and influencing without authorityintermediate
- Professional delivery of crucial conversationsintermediate
- Proactive planning, prioritization, and anticipation of problemsintermediate
- Compliance with internal and regulatory requirementsintermediate
Required Qualifications
- Proficiency in providing analytical and customized need-based solutions to problems in complex environments and matrix influenced health systems and practices (experience)
- Demonstrates the ability to lead without authority and effectively communicate with diverse groups with sometimes different priorities (experience)
- Capable of influencing across functions to gain consensus on agreed upon patient solutions (experience)
- Ability to professionally deliver crucial conversations that may contain less than desirable information or facts (experience)
- Proactively engage in Field Input Teams offering innovative solutions to problems in a fast-paced changing environment (experience)
- Demonstrate effective planning, prioritization, follow up, and anticipates problems (experience)
Responsibilities
- Shares expertise and educates on Medical and Pharmacy benefits, Buy & Bill and Specialty Pharmacy acquisition, payor policy, appropriate patient identification, clinical documentation, benefit investigation results, prior authorizations, billing, coding, patient tracking, claim submission, reconciliation management, patient financial savings programs, patient tracking/retreatment, and the denial/appeal process for the approved indications for BOTOX® Therapeutics
- Clarifies barriers that may impede or delay appropriate patient access to treatment and/or prevent optimal patient outcomes
- Interacts with healthcare providers, administrative staff, revenue cycle management, and institutional leadership
- Offers approved tools and standardization methods to provide reimbursement and technical knowledge to gain patient access while reducing access challenges
- Educates on the fundamentals of the BOTOX treatment process, appropriate reimbursement, and understanding the payer landscape
- Leverages advanced problem-solving and analytical skills to identify access and reimbursement barriers while offering actionable insights to desired and approved care
- Uncovers the root cause to access issues impeding or delaying proper treatment
- Monitors and provides updates on both Region and National Payers, including changes or barriers in medical policy, Prior Authorization requirements, or product acquisition, and applies compliant methods to exchange critical information
- Works collaboratively and functions as a liaison for information between various internal stakeholders such as Market Access, Center of Excellence, Sales, Marketing, Training, Compliance, Trade, and Specialty Pharmacy groups
- Provides customer feedback relating to approval requirements and access to care barriers with AbbVie stakeholders
- Educates accounts on need-based tools to support patient access, including HUB services, patient savings programs, payer coverage details, and acquisition pull-through initiatives
- Establishes and maintains respectful working relationships with healthcare professionals and staff as well as business-oriented decision makers including C-Suite level executives within territory
- Shares customer challenges and suggests potential solutions to address obstacles
- Conducts all work activities in compliance with all AbbVie internal requirements and with all applicable regulatory requirements
Benefits
- general: Patient financial savings programs
- general: HUB services
- general: Patient savings programs
- general: Payer coverage details
- general: Acquisition pull-through initiatives
Tags & Categories
Field Reimbursement Manager - Botox Therapeutic
AbbVie
Field Reimbursement Manager - Botox Therapeutic
Job Description
The Reimbursement Business Advisor (RBA) shares expertise and educates on Medical and Pharmacy benefits, Buy & Bill and Specialty Pharmacy acquisition, payor policy, appropriate patient identification, clinical documentation, benefit investigation results, prior authorizations, billing, coding, patient tracking, claim submission, reconciliation management, patient financial savings programs, patient tracking/retreatment, and the denial/appeal process for the approved indications for BOTOX® Therapeutics. The RBA clarifies barriers that may impede or delay appropriate patient access to treatment and/or prevent optimal patient outcomes. The RBA may interact with healthcare providers, administrative staff, revenue cycle management, and institutional leadership.After the patient has been identified by an ABS provider, the RBA offers approved tools and standardization methods to provide reimbursement and technical knowledge to gain patient access while reducing access challenges.Educate on the fundamentals of the BOTOX treatment process, appropriate reimbursement, and understanding the payer landscapeLeverages advance problem-solving and analytical skills to identify access and reimbursement barriers while offering actionable insights to desired and approved careUncover the root cause to access issues impeding or delaying proper treatmentMonitor and provide updates on both Region and National Payers. Examples include changes or barriers in medical policy, Prior Authorization requirements, or product acquisition. Apply compliant methods to exchange critical informationWork collaboratively and function as a liaison for information between various internal stakeholders such as: Market Access, Center of Excellence, Sales, Marketing, Training, Compliance, Trade, and Specialty Pharmacy groups.Provide customer feedback relating to approval requirements and access to care barriers with AbbVie stakeholders (Market Access, Center of Excellence, Sales, Marketing, Trade, Specialty Pharmacy, Senior Leadership) Educate accounts on need-based tools to support patient access. Examples include HUB services, patient savings programs, payer coverage details, and acquisition pull-through initiativesProficient in providing analytical and customized need-based solutions to problems in complex environments and matrix influenced health systems and practicesEstablish and maintain respectful working relationships with healthcare professionals and staff as well as business-oriented decision makers including C-Suite level executives within territoryDemonstrates the ability to lead without authority and effectively communicate with diverse groups with sometimes different prioritiesCapable of influencing across functions to gain consensus on agreed upon patient solutionsAbility to professionally deliver crucial conversations that may contain less than desirable information or factsProactively engage in Field Input Teams offering innovative solutions to problems in a fast-paced changing environmentShare customer challenges and suggest potential solutions to address obstaclesDemonstrate effective planning, prioritization, follow up, and anticipates problemsThe employee conducts all work activities in compliance with all AbbVie internal requirements and with all applicable regulatory requirements
Locations
- Detroit, MI
Salary
106,500 - 202,500 USD / yearly
Estimated Salary Rangemedium confidence
100,000 - 150,000 USD / yearly
Source: AI estimated from job description
* This is an estimated range based on market data and may vary based on experience and qualifications.
Skills Required
- Expertise in reimbursement processes including medical and pharmacy benefits, buy & bill, specialty pharmacy acquisition, payor policy, prior authorizations, billing, coding, claim submission, and denial/appeal processesintermediate
- Advanced problem-solving and analytical skillsintermediate
- Knowledge of payer landscape and monitoring changes in medical policy and prior authorization requirementsintermediate
- Collaborative liaison skills across internal stakeholdersintermediate
- Effective communication and influencing without authorityintermediate
- Professional delivery of crucial conversationsintermediate
- Proactive planning, prioritization, and anticipation of problemsintermediate
- Compliance with internal and regulatory requirementsintermediate
Required Qualifications
- Proficiency in providing analytical and customized need-based solutions to problems in complex environments and matrix influenced health systems and practices (experience)
- Demonstrates the ability to lead without authority and effectively communicate with diverse groups with sometimes different priorities (experience)
- Capable of influencing across functions to gain consensus on agreed upon patient solutions (experience)
- Ability to professionally deliver crucial conversations that may contain less than desirable information or facts (experience)
- Proactively engage in Field Input Teams offering innovative solutions to problems in a fast-paced changing environment (experience)
- Demonstrate effective planning, prioritization, follow up, and anticipates problems (experience)
Responsibilities
- Shares expertise and educates on Medical and Pharmacy benefits, Buy & Bill and Specialty Pharmacy acquisition, payor policy, appropriate patient identification, clinical documentation, benefit investigation results, prior authorizations, billing, coding, patient tracking, claim submission, reconciliation management, patient financial savings programs, patient tracking/retreatment, and the denial/appeal process for the approved indications for BOTOX® Therapeutics
- Clarifies barriers that may impede or delay appropriate patient access to treatment and/or prevent optimal patient outcomes
- Interacts with healthcare providers, administrative staff, revenue cycle management, and institutional leadership
- Offers approved tools and standardization methods to provide reimbursement and technical knowledge to gain patient access while reducing access challenges
- Educates on the fundamentals of the BOTOX treatment process, appropriate reimbursement, and understanding the payer landscape
- Leverages advanced problem-solving and analytical skills to identify access and reimbursement barriers while offering actionable insights to desired and approved care
- Uncovers the root cause to access issues impeding or delaying proper treatment
- Monitors and provides updates on both Region and National Payers, including changes or barriers in medical policy, Prior Authorization requirements, or product acquisition, and applies compliant methods to exchange critical information
- Works collaboratively and functions as a liaison for information between various internal stakeholders such as Market Access, Center of Excellence, Sales, Marketing, Training, Compliance, Trade, and Specialty Pharmacy groups
- Provides customer feedback relating to approval requirements and access to care barriers with AbbVie stakeholders
- Educates accounts on need-based tools to support patient access, including HUB services, patient savings programs, payer coverage details, and acquisition pull-through initiatives
- Establishes and maintains respectful working relationships with healthcare professionals and staff as well as business-oriented decision makers including C-Suite level executives within territory
- Shares customer challenges and suggests potential solutions to address obstacles
- Conducts all work activities in compliance with all AbbVie internal requirements and with all applicable regulatory requirements
Benefits
- general: Patient financial savings programs
- general: HUB services
- general: Patient savings programs
- general: Payer coverage details
- general: Acquisition pull-through initiatives
Tags & Categories