Bausch + Lomb Pharma - Field Reimbursement Manager, Southwest

Date: Jul 27, 2022

Location: US

Company: Bausch & Lomb

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 nearly 170-year history. We have a significant global research, development, manufacturing and commercial footprint of approximately 12,500 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. 

 

Responsibilities

The Field Reimbursement Manager (FRM) will provide field-based support and expertise to help resolve patient access issues, educate offices and hospitals on appropriate billing and coding for Bausch & Lomb, Inc. products, and provide educational services within relevant sites of care. The FRM will work directly with office support staff, hospital billing and coding staff, third party vendors (Focus on Access – HUB, Savings Card, Patient Assistance Program - PAP), and other important stakeholders involved with supporting patient access to B+L therapies. FRMs will 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.

 

  • The FRM will manage daily activities that support appropriate patient access to Bausch & Lomb, Inc. products across relevant sites of care to work as an extension of the patient assistance and reimbursement support services offered to providers.
  • Review patient benefit options, prior authorization requirements, and alternate funding/financial assistance programs.
  • Review appropriate billing and coding for products, assist with resolving reimbursement issues, and help ensure appropriate education to avoid future reimbursement hurdles.
  • Coordinate with Bausch & Lomb, Inc. patient support services programs (HUB) representatives on patient cases and claim issues.
  • Educate office staff on the use of Bausch & Lomb, Inc. 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, Inc. 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.
  • Attend and support relevant regional society meetings, coordinating support with TMs and Brand.
  • Assist providers with understanding local payer coverage and reimbursement trends through educational breakfast, lunch, and dinner programs.
  • Lead sales training related to product reimbursement, as appropriate.
  • Communicate reimbursement concerns and issues with appropriate internal stakeholders, including Sales and Managed Markets.
  • Understand and monitor national and regional payer trends and changes.
  • Work collaboratively with Managed Markets team to escalate potential payer issues.
  • Coordinate travel schedules to attend important access meetings with Sales Force.
  • 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 be able to assist prescribers and their staff with addressing barriers to appropriate patient access to B+L’s products, which requires a broad knowledge of the claim’s revenue cycle process.
  • The FRM must also 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
  • Ability to develop relationships with medical directors within a payer.
  • 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).
  • The FRM should have a 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.

 

Comprehensive Benefits

We recognize your physical, financial, and emotional wellbeing is a significant part of what allows you to be successful at work and at home. Our generous benefits package includes:

  • Medical, Dental, and Vision Coverage
  • Flexible Spending Account (FSA)
  • Life Insurance
  • 401(k) Savings Plan
  • Employee Stock Purchase Plan
  • Employee Assistance Plan (EAP)
  • Parental Leave Program
  • Free Bausch + Lomb Contact Lenses
  • Group Legal Services
  • Education Assistance Program
  • Adoption Benefits

 

Learn more at www.bausch.com

  

 

This position may be available in the following location(s): US - Remote

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.