Field Reimbursement Manager, Central

Location: Central

Position Summary:

The Field Reimbursement Manager (FRM) serves as key field-based expert in market access and reimbursement, and the subject matter expert in navigating the reimbursement and access landscape for healthcare providers, office staff, and other critical stakeholders. This role provides education across the entire access journey, with deep expertise in claims submissions, prior authorization processes, coverage criteria, and payer-specific requirements across commercial, Medicare, and Medicaid plans.

Success in this role requires strong business acumen, an understanding of the national payer environment, and the ability to build trusted relationships with provider offices, HUB services, pharmacies, and internal cross-functional partners. The FRM ensures a positive customer experience by delivering clear guidance, resolving issues efficiently, and supporting timely and appropriate patient access to therapy.

Responsibilities:

• Proactively address patient access barriers by working with customers and accounts to resolve complex reimbursement issues, including prior authorizations, appeals, and denials.
• Educate private practices, multi-specialty groups, facilities, and their staff on reimbursement support programs, coverage, coding, and payer policies.
• Accountable for ensuring access barriers are minimized, for appropriate patients, to obtain Invivyd products through HCP education.
• Have a thorough understanding of payor policies and navigating the coverage landscape.
• Deliver clear and actionable information to practice managers, billing staff, nurses, and reimbursement teams to improve their understanding of payer policies and processes.
• Conduct regular reviews with practices to understand their utilization of reimbursement support services and recommend program enhancements based on customer needs.
• Report payor trends related to approved products to Patient Services and Market Access account management teams  
• Have a deep understanding of coverage pathways to access, for both medical and pharmacy benefit products
• Have a deep understanding of the Medicare reimbursement landscape.
• Provide expertise within the national/regional payor landscape in order to educate providers on navigating the reimbursement process and payer trends.
• Provide training to healthcare professionals on the drug reimbursement process, coding, and billing practices.
• Navigate and manage access and reimbursement concerns by pulling in the appropriate Invivyd stakeholder. Stay informed about relevant business trends, competitive landscape, regulatory changes, and healthcare policy developments that may impact our customers.
• Leverage market insights to anticipate customer needs and develop strategies that maintain a competitive edge.
• Exhibit executive presence to provide presentations on insights and trends to commercial and executive leadership.
• Ensure that all activities and interactions adhere to relevant pharmaceutical regulations, industry standards, and ethical guidelines.

Requirements: 

• Bachelor's Degree
• 8+ years of experience in pharmaceutical or biotechnology, with experience in Market Access, Payer Account Management, and/or Access and Reimbursement
• Capability to develop strategic account plans and oversee contract performance to ensure ongoing business health.
• Proven track record of success, meeting or exceeding business KPIs.
• Working knowledge of the formulary inclusion process and familiarity with sub-committees.
• Analytical mindset with the ability to interpret sales data, market trends, and customer insights.
• Experience working in CRM systems and sales analytics tools.
• Ability to travel as required ~60% of the time to meet with customers and attend industry events.

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