Field Reimbursement Manager/Sr. Field Reimbursement Manager I

Location
Working from home
Posted
Jul 08, 2021
Ref
1871
Required Education
Bachelors Degree
Position Type
Full time
Field Reimbursement Manager/Sr. Field Reimbursement Manager I - SE Region

As the Field Reimbursement Manager/Sr. Field Reimbursement Manager I, you will be responsible for supporting all compliant aspects of the US reimbursement support within the Southeast Region which includes site of care (Ambulatory Service Centers or Hospital Outpatient Surgery Centers). As a field based commercial role, you will expand the access to reimbursement of, as well as the education of, Omeros products in a non-promotional manner. Omidria® support activities are intended to facilitate patient access to Omidria® and associated patient support programs when prescribed for a patient. The SE region includes Florida, Georgia, North Carolina, and South Carolina.

Good things are happening at Omeros!

Come and be a part of our Reimbursement Team!

Who is Omeros?

True innovation requires the right people, and that's what we have at Omeros - smart, hard-working and creative individuals who collaborate and drive to achieve what has not yet been done. We see strength in diversity - diversity in thought, expertise and experience.

We have taken a similar approach in structuring our company. While many biotechs pursue a single therapeutic area or scientific platform, we are strategically building a deep and diverse pipeline of first-in-class small-molecule and antibody therapeutics. The strength of our scientific discoveries and exclusive intellectual property positions enable our pipeline programs to target highly promising receptors and enzymes that others have not been able to develop.

Although cutting across a wide and diverse range of disorders and therapeutic indications - some orphan, others large-market and many for which there are no approved treatments - all of our drugs on the market and in development target critical unmet needs to improve the lives of patients in meaningful ways.

Essential Duties & Responsibilities:

  • Implements strategies and tactics to appropriately support billing and reimbursement across various sites of care through a plan with potential solutions that would impact access across multiple stakeholders
  • Educates customers/appropriate personnel on the following:
    • Omidria® access option(s) available to Customers by providing information on the coverage, coding, and billing options and patient support services that may apply to OMIDRIA using Promotional Review Committee (PRC) approved materials and messaging
    • Appropriate documentation for billing and claims appeals
    • Appropriate billing and coding for separable billable and ambulatory surgical center bundled payment
    • In the utilization of OMIDRIAssure patient access programs and reactively addresses PAP questions per Omeros policy
    • The process for completing and submitting proper forms to payers (e.g., statements of medical necessity (SMNs), prior authorizations (PAs), coding, coding, claims, appeals, denials) to obtain or maintain appropriate access for Commercial, Medicare, Medicare Advantage, and Medicaid patients
    • With resolution of patient-level claims issues, supporting access to Omidria® as appropriate
    • On important coverage, coding and formulary changes within assigned territories or accounts
  • Provides information on payer policies and procedures, including coverage inside the bundle and separable billable claims
  • Reactively research coding and claims-related questions by collaborating with the Omeros Payer team or HUB for payer specific information and policies in order to understand policies - and to accurately complete and document claims per payer requirements
  • Participates at the Omeros commercial booth during national, regional and local medical conventions, conferences and meetings providing reimbursement support
  • Responds to questions about Average Sales Price (ASP), if the information is publicly available (e.g., Medicare rates) but may not market the spread
  • Identifies local payment or coverage trends through contact with customers while in the field
  • Assists and supports the development of internal reimbursement training tools or customer facing promotional materials
  • Responsible for complying with all applicable compliance rules and regulations pertaining to the selling, marketing and distribution of Omidria® or any other company products
Education, Experience, Skills, and Knowledge Required:
  • Bachelor's degree in Business, Marketing, or Life Sciences with a minimum of 2 - 5 years of reimbursement experience (or MBA with a minimum of 2 years of reimbursement experience) for a Field Reimbursement Manager or a minimum of 5 - 8 years of reimbursement experience (or MBA with a minimum of 3 - 6 years of reimbursement experience) for a Sr. Field Reimbursement Manager I
  • Demonstrated understanding of billing, coding, and claims submission process for buy-and-bill products with separable billable and case rate bundled reimbursement across Commercial, Medicare and Medicaid
  • Experience with a "start-up" bio pharma company and/or at least one product launch desirable in which reimbursement and coding experience was the focus
  • Experience and familiarity with ophthalmology, pharmaceutical or device products desirable
  • Demonstrated problem-solving capabilities and analytical skills
  • Outstanding consultative and networking capabilities and, relationship building skills
  • Good communication, planning and organizational skills
  • Ability to work collaboratively, effectively and efficiently with internal and external partners
  • Excellent understanding and knowledge of the compliance guidelines for Field Reimbursement interactions
Behavioral Competencies Required:
  • Demonstrated ability to build and maintain positive relationships with customers, management and peers
  • Integrity
  • Business acumen
  • Influence and persuasiveness
  • Customer focus
  • Goal focused
  • Initiative and follow-up
  • Ethics and compliance
  • Integrity and personal credibility
Other Requirements:
  • Ability to travel up to 60% of the time with occasional overnight travel
  • Valid driver's license and an acceptable driving record
  • Must reside within the geographical region
If you have the experience, skills and knowledge we are seeking, we'd love to hear from you! This is an exciting opportunity for the right person!

Omeros is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status such as race, religion, color, national origin, sex, age, marital status, or any other factor determined to be unlawful by federal, state, or local statutes.

It is our policy to provide reasonable accommodation to anyone with a disability who needs assistance completing the job application process. If you need assistance, you can either send an e-mail to hr@omeros.com or contact Omeros, asking for Human Resources, at (206) 676-5000.