Field Reimbursement Manager (West)
Company: Bausch + Lomb
Location: Los Angeles
Posted on: April 28, 2024
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Job Description:
Bausch + Lomb (NYSE/TSX: BLCO) is a leading global eye health
company dedicated to protecting and enhancing the gift of sight for
millions of people around the world-from the moment of birth
through every phase of life. Our mission is simple, yet powerful:
helping you see better, to live better.
Our comprehensive portfolio of over 400 products is fully
integrated and built to serve our customers across the full
spectrum of their eye health needs throughout their lives. Our
iconic brand is built on the deep trust and loyalty of our
customers established over our 170-year history. We have a
significant global research, development, manufacturing, and
commercial footprint of approximately 13,000 employees and a
presence in approximately 100 countries, extending our reach to
billions of potential customers across the globe. We have long been
associated with many of the most significant advances in eye
health, and we believe we are well positioned to continue leading
the advancement of eye health in the future.
Overview
The Field Reimbursement Manager (FRM) is a field-based
non-promotional position who will use their extensive knowledge of
insurance coverage, patient assistance programs, and the local
reimbursement landscape to provide support to Healthcare
Professional's offices and their patients to obtain appropriate
access to Bausch + Lomb's products. This role supports Bausch +
Lomb's retina product portfolio and business reimbursement strategy
and requires strong skills in navigating across multiple functions
and departments and among program vendors to provide an excellent
customer experience.
Responsibilities
Work directly with office support staff, third party vendors (ex.
HUBs), and other important stakeholders involved with supporting
patient access to Bausch + Lomb therapies.
Develop Key Opinion Leader (KOL) relationships, be involved in
payer monitoring and support across Medicare Contractors and lead
the relationship with Medicare Contractor Medical Directors.
Subject matter expert on Bausch + Lomb's patient support programs,
payer utilization management, access issue resolution, financial
assistance and Company approved alternative funding options.
Develop business plans, tailored to the applicable geography and
customer, to execute brand strategies that are consistent with
corporate brand and marketing plans.
Establish and maintain knowledge on the local and national payer
landscape - this includes Specialty Pharmacy and Utilization
Management criteria for assigned products.
Manage daily activities and provide support for appropriate patient
access to Bausch + Lomb products across relevant sites of care.
Educate office staff and providers on the use of Bausch + Lomb
patient assistance and reimbursement support services, including
but not limited to web-based provider programs and tools, and
provide information on relevant reimbursement topics related to
Bausch + Lomb products.
Help develop KOL relationships in collaboration with Territory
Managers (TMs) and National Account Directors (NADs) related to
payer initiatives.
Monitor and attend Open Contractor Administrative Committee (CAC)
Meetings for designated Medicare Administrative Contractors
(MACs).
Conduct policy surveillance across regional MACs to ensure
appropriate coding, coverage, and payment of B+L products.
Provide education and information to regional societies working
with the Brand and Territory Managers.
Lead sales training related to product reimbursement, as
appropriate.
Work collaboratively with Managed Markets to resolve potential
reimbursement obstacles and issue.
Communicate reimbursement concerns and issues with appropriate
internal stakeholders, including Managed Markets.
Conduct pre-call planning meetings with TMs to ensure objectives
and goals for each visit are established.
Qualifications
Bachelor's degree required; advanced degree preferred.
Minimum of two years of experience in public or private third-party
reimbursement; previous field reimbursement manager experience
preferred.
Must have worked with a pharmaceutical, biotech, or device
manufacturer sales team in a reimbursement capacity or as a
contract position through a reimbursement consulting agency.
Must have specific practice management, billing and/or coding
experience for drugs, biologicals, or devices under a "buy & bill"
and specialty pharmacy model.
Must have a good understanding of the claim's revenue cycle process
to appropriately assist prescribers and their staff.
Must possess an understanding of reimbursement considerations from
a patient and provider perspective, with an ability to effectively
interact and navigate within various sites of care (i.e., physician
office, hospital outpatient department, ambulatory surgery center,
etc.).
Must have general payer policy knowledge including public and
private payers, foundational knowledge of benefit verifications and
prior authorization/pre-determination requirements and knowledge of
reimbursement processes within various sites of care.
All reimbursement activities are required to be conducted and
managed within all appropriate legal and regulatory guidelines and
require continuous monitoring of compliance with such guidelines
and laws.
Public speaking / presentations / education experience
required.
Demonstrated ability to conduct field-based reimbursement support
and education.
Experience with reimbursement billing, coding, and appeals
process.
Experience with new product launches, including billing with a
miscellaneous HCPCS code, miscellaneous CPT code, and / or
transition to billing with a unique HCPCS code.
Knowledge of private payer, Medicare and Medicaid structure,
systems, and reimbursement process.
Ability to analyze and interpret regulation and legislation.
Project management skills.
Ability to work independently, manage travel schedules, schedule
visits (territory management).
Ability to travel overnight for three nights per week.
Strong computer skills (PowerPoint, Word, Excel).
Travel expectation of 50-70%.
You may be required to provide hospitals proof of childhood
immunizations, a negative TB test and other requirements, as set by
the hospital protocol for access.
As required by Colorado's Salary Transparency Law, Bausch + Lomb
provides a good faith minimum and maximum salary range of
compensation for roles that can or will be performed, in Colorado.
Actual compensation is influenced by a wide array of factors
including but not limited to skill set, level of experience, and
specific office location. For Colorado, the range of starting
annual base pay for this role is $150,000 - $175,000.
As required by California's Salary Transparency Law, Bausch + Lomb
provides a good faith minimum and maximum salary range of
compensation for roles that can or will be performed, in
California. Actual compensation is influenced by a wide array of
factors including but not limited to skill set, level of
experience, and specific office location. For California, the range
of starting annual base pay for this role is $150,000 -
$175,000.
As required by Washington's Salary Transparency Law, Bausch + Lomb
provides a good faith minimum and maximum salary range of
compensation for roles that can or will be performed, in
Washington. Actual compensation is influenced by a wide array of
factors including but not limited to skill set, level of
experience, and specific office location. For Washington, the range
of starting annual base pay for this role is $150,000 -
$175,000.
All qualified applicants will receive consideration for employment
without regard to race, color, religion, sex, sexual orientation,
gender identity, national origin, disability, or veteran
status.
Job Applicants should be aware of job offer scams perpetrated
through the use of the Internet and social media platforms.
To learn more please read Bausch+Lomb's Job Offer Fraud Statement
(https://hcm2preview.sapsf.eu/bauschhealT4/Bausch_job_posting_statement.docx)
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Our Benefit Programs: https://www.bausch.com/careers/benefits/
Applicants must be authorized to work for ANY employer in the U.S.
We are unable to sponsor or take over sponsorship of an employment
Visa at this time.
Keywords: Bausch + Lomb, La Mirada , Field Reimbursement Manager (West), Executive , Los Angeles, California
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