Field Reimbursement Manager - Midwest

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.

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.

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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.