[Hiring] Senior Field Reimbursement Specialist @Cencora

Role Description

The Sr Field Reimbursement Specialist (FRS) will plan and engage with health systems, hospitals, academic medical centers, authorized treatment centers, and other institutional stakeholders to provide education on access, reimbursement, and operational considerations relevant to an assigned client’s rare disease cell and gene therapy (CGT) product.

• Manage daily activities that support appropriate patient access to the client’s products within health systems, hospital outpatient departments, academic and community institutions, authorized treatment centers, and aligned provider offices.
• Act as a liaison to patient assistance, reimbursement support, and access services offered by the client.
• Educate health systems, hospitals, academic medical centers, authorized treatment centers, and provider office staff on payer coverage, benefit design, and reimbursement considerations for rare disease and cell and gene therapy products.
• Validate and educate stakeholders on prior authorization requirements, including clinical eligibility criteria and appeal processes.
• Demonstrate understanding of specialty pharmacy, specialty distribution, and institutional acquisition pathways.
• Identify alternate funding, financial assistance, copay support, and other appropriate access resources for eligible patients.
• Apply effective account management within complex health systems by uncovering customer insights and identifying account-level access barriers.
• Educate stakeholders on evolving CGT reimbursement constructs, including outcomes-based agreements and applicable CMS payment models.
• Monitor and communicate local and regional payer coverage trends.
• Coordinate with authorized treatment center site coordinators and other stakeholders to support operational readiness and continuity of care.
• Deliver interactive educational presentations and in-services at health systems and provider sites of service.
• Prioritize activities and abide by approved processes to maximize effective coverage of assigned accounts.
• Lead internal team training and meetings.
• Develop and execute business plan for assigned territory.
• Perform other related duties as assigned.

Qualifications

• Bachelor’s degree preferred.
• Minimum of 7 years of relevant experience, including experience in field reimbursement, health system access, patient access, market access, revenue cycle, managed care, or institutional reimbursement support.
• Demonstrated experience working within health systems, hospitals, academic medical centers, or authorized treatment centers required.
• Experience with rare disease, cell and gene therapy, specialty biologics, oncology/hematology, or other complex therapeutic areas strongly preferred.
• Candidates must possess a Prior Authorization Certification Specialist (PACS) credentials or obtain certification within the first six months of employment.

Requirements

• Ability to effectively manage multiple client relationships and customer interactions.
• Proven teamwork and collaboration skills.
• Ability to manage multiple tasks, timelines, and activities necessary to fulfill the roles and responsibilities of a Field Reimbursement Specialist.
• Sound judgment and decision-making ability with a high degree of emotional intelligence.
• Creative problem-solving skills.
• Excellent communication skills with the ability to present complex information in both informal and formal settings.
• Broad understanding of health system reimbursement and related processes.
• Deep understanding of medical and pharmacy benefits, payer policies, and appeal requirements for complex therapies.

Benefits

• Comprehensive suite of benefits focusing on physical, emotional, financial, and social wellness.
• Support for working families, including backup dependent care, adoption assistance, and infertility coverage.
• Paid parental leave and paid caregiver leave.
• Variety of training programs and professional development resources.
• Opportunities to participate in mentorship programs and volunteer activities.