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Field Reimbursement Manager

3-5 years
Not Disclosed
10 April 30, 2025
Job Description
Job Type: Full Time Education: B.Sc./M.Sc/B.Pharm/M.Pharm/Life Science Skills: Causality Assessment, Clinical SAS Programming, Communication Skills, CPC Certified, GCP guidelines, ICD-10 CM Codes, CPT-Codes, HCPCS Codes, ICD-10 CM, CPT, HCPCS Coding, ICH guidelines, ICSR Case Processing, Interpersonal Skill, Labelling Assessment, MedDRA Coding, Medical Billing, Medical Coding, Medical Terminology, Narrative Writing, Research & Development, Technical Skill, Triage of ICSRs, WHO DD Coding

 

Title: Field Reimbursement Manager
Date Posted: April 25, 2025
Location: Sun - FS California, Los Angeles
Company: Sun Pharmaceutical Industries, Inc. (USA)


Job Overview:

The Field Reimbursement Manager is a part of the Market Access group supporting Sun’s branded products in the U.S. The primary goal of this role is to ensure appropriate patient access to care by supporting practices, accounts, and providers. This includes offering necessary support materials and education related to coverage, coding, payment, specialty pharmacy, and patient assistance programs. The role also involves monitoring payer policies and developing relationships with key advocacy leaders and state societies.


Area of Responsibility:

  • Execute local market plans to support field-based priorities

  • Educate and understand local health policy, reimbursement, billing/coding, and patient access issues

  • Collaborate with field partners to alleviate reimbursement and access issues impacting physician offices

  • Work with access services hub, managed markets team, and local field sales teams

  • Monitor payer policies and healthcare trends to maximize access to Sun products


Key Responsibilities:

  • Maximize access to Sun products through an understanding of dynamic marketplace trends

  • Deep knowledge of medical vs pharmacy benefits and policies

  • Understand the dynamics of specialty pharmacy and specialty distribution

  • Knowledge of physician buy-and-bill model vs assignment of benefits to alternate sites of care

  • Expertise in Medicare policies and their variations

  • Ensure effective communication with sales teams and support pull-through efforts

  • Effectively communicate with customers using proper terminology, selling, and negotiation skills

  • Maintain thorough knowledge of Sun products

  • Regularly communicate with managers and other support teams

  • Participate in teleconference, live National, regional, and district meetings, and conventions when needed

  • Ensure compliance with Healthcare Compliance guidelines


Job Qualifications:

  • Education: Minimum of a Bachelor’s Degree

  • Experience:

    • 5+ years of healthcare industry experience, including:

      • 3+ years of experience in insurance verification, claim adjudication, medical benefit procurement, and billing

      • Expertise in Commercial and Government payers, buy-and-bill models, and Medicare, Medicaid, Tricare

    • Experience in Dermatology and/or Oncology is a plus

  • Additional Skills:

    • Proven teamwork and collaboration skills

    • Strong verbal and written communication skills

    • Strong presentation and analytical skills

    • Ability to manage competing priorities

    • Experience in Sun Pharma’s therapeutic areas (Dermatology, Oncology, Biologics) preferred


Job Location: Los Angeles, California
Company Location: Sun Pharmaceutical Industries, Inc. (USA)