Field Reimbursement Manager - New England (Healthcare)

Location: US - Massachusetts - Boston; territory includes Boston, Worcester, Manchester, Hartford, Providence, and Portland. Hybrid field role with two days per week in the geography, one to two home-office days per week, and up to 40% travel by automobile or plane. Candidates must live in the geography or within 10 miles of its border. Relocation is not included.

Annual salary: $145,471–$196,813 USD.

Company

hirify.global is a biotechnology company developing and delivering medicines for serious illnesses across oncology, inflammation, general medicine, and rare disease.

What you will do

• Manage defined accounts and execute the territory strategy for Patient Access and Reimbursement in the Bone Health business unit.
• Provide live coverage support as an extension of the HUB and guide healthcare providers from physician order through reimbursement.
• Support prior authorization, appeals, claims resolution, benefits investigation, and alternative funding programs.
• Educate healthcare providers on commercial, Medicare, and Medicaid coverage, formulary criteria, utilization management, and insurance procedures.
• Review patient-specific information and resolve coverage challenges involving protected health information.
• Coordinate reimbursement issues with HUB and cross-functional partners and communicate payer changes across the territory.

Requirements

• Doctorate degree; or a master's degree plus 3 years of customer service or leadership experience; or a bachelor's degree plus 5 years; or an associate's degree plus 10 years; or a high school diploma/GED plus 12 years.
• Experience directly managing people or leading teams, projects, programs, or resource allocation.
• At least 2 years of experience in public or private third-party access, managed care, clinical support, sales, or the pharmaceutical industry.
• Strong medical reimbursement, specialty pharmacy, Buy & Bill, billing, coding, appeals, and HUB experience.
• Experience with commercial payers, Medicare plans, and state Medicaid, plus strong presentation, communication, collaboration, and project management skills.
• Valid driver's license with a clean driving record and ability to travel up to 40%.

Nice to have

• Bachelor's degree in business, healthcare, or a related field.
• Six years of experience with specialty or biologic self-injectable products or physician-administered Buy & Bill products.
• Advanced medical insurance terminology knowledge and expertise in CMS policies, Medicare Part B, and Medicare Part D.
• Ability to manage ambiguity, solve problems, and manage expenses within allocated budgets.

Culture & Benefits

• Collaborative, innovative, and science-based work environment.
• Health, dental, and vision coverage, life and disability insurance, and flexible spending accounts.
• Retirement and savings plan with company contributions.
• Annual bonus or sales-based incentive plan, stock-based long-term incentives, and paid time off.
• Flexible work models, including remote and hybrid arrangements where applicable.

Hiring process

• Applications are accepted until a sufficient number of applications are received or a candidate is selected.
• Sponsorship for this role is not guaranteed.