Field Reimbursement Manager (FRM), Ophthalmology – United States

This posting is intended to proactively build a pipeline of talent for roles we anticipate may open in the future. It is not tied to an active vacancy at this time. By applying to this Pipeline Advertisement, candidates are expressing interest in being contacted for potential future opportunities that align with the role described.

Why Ophthalmology. Why Merck. Why now.

Merck is advancing research focused on retinal diseases and developing therapies aimed at protecting, restoring and improving vision for people living with eye diseases. For experienced professionals, this is an opportunity to apply your expertise in an area where scientific research, customer engagement and patient-focused work come together.

Explore Ophthalmology Opportunities

For those who want to combine scientific curiosity, customer engagement, strategic influence and meaningful impact, ophthalmology at Merck offers an opportunity to contribute to work connected to retinal disease research and customer partnership.

Job Description:

The Field Reimbursement Manager (FRM), Ophthalmology serves as the subject-matter expert on access-related issues for healthcare professionals (HCPs) and healthcare organizations (HCOs), and works cross-functionally with Patient Support Services, Market Access, Account Management, Medical Affairs, and Field Sales to support timely patient access to therapy. The FRM provides information and education to healthcare providers on access processes, reimbursement considerations, payer coverage policies, and patient support programs while ensuring compliance with healthcare regulations and company policies. The role is aligned with the organization's non-promotional field access model and serves as a key resource supporting appropriate patient access following a prescribing decision.

The FRM role is a remote, field-based position that proactively provides approved education to defined accounts within an assigned geography on matters related to reimbursement, payer coverage, and patient access. The FRM analyzes access challenges, acts as the local reimbursement resource for HCPs and internal field teams, and supports coordination with approved patient support programs and HUB services where appropriate. The FRM collaborates closely with National Account Directors, Key Account Managers, Patient Support Services, Market Access, Trade, Specialty Pharmacy partners, and other customer-facing teams while complying with all corporate, legal, regulatory, and compliance requirements.

Joining this team means helping ophthalmology practices navigate a complex reimbursement and access environment by building reimbursement confidence, supporting buy-and-bill operational readiness, and helping practices understand the resources available to support appropriate patient access.

Key Responsibilities:

• Provide approved information and education to healthcare provider offices regarding patient access, including benefit verification, prior authorization processes, appeals processes, coding and billing considerations, and patient support programs through both in-person and virtual interactions.
• Analyze access trends and reimbursement challenges that impact patient access and communicate insights through approved channels.
• Partner cross-functionally to identify and address barriers to patient access while supporting positive customer experiences.
• Build collaborative and trusted relationships with retina specialists, ophthalmologists, practice administrators, reimbursement personnel, billing staff, and internal stakeholders.
• Monitor payer trends, reimbursement requirements, and payer policy changes that may impact patient access.
• Provide approved access and reimbursement information to healthcare provider offices and internal stakeholders as permitted by policy.
• Escalate and coordinate reimbursement and access issues with approved third-party support organizations, including HUB vendors and patient support programs.
• Educate and support healthcare provider offices regarding specialty pharmacy processes when appropriate.
• Provide information regarding commercial, Medicare Part B, and Medicaid coverage considerations and how therapies may be covered within established benefit structures.
• Answer questions related to payer coverage requirements and approved reimbursement support resources.
• Maintain deep knowledge of regional and national market dynamics, payer coverage policies, reimbursement trends, and healthcare access considerations.
• Serve as a subject matter expert on reimbursement, affordability, and patient access challenges across Medicare, Medicaid, and commercial payer channels.
• Educate and update healthcare providers regarding payer policy changes that impact patient access.
• Support buy-and-bill access and reimbursement readiness within retina and ophthalmology practices through approved education and resources.
• Educate healthcare providers regarding HUB services, patient support offerings, affordability resources, and available reimbursement support tools.
• Attend national, regional, and territory meetings as required.

Minimum Requirements:

• Bachelor’s Degree required.
• Minimum 7 years of experience in patient support, healthcare sales, healthcare operations, project management, reimbursement support, specialty pharmacy, market access, provider office reimbursement, or related healthcare environments.
• Strong knowledge of health insurance structures including Medicare Part B, Medicaid, and commercial insurance, along with related access processes such as benefit verification, prior authorization, reimbursement support, and appeals processes.
• Strong understanding of buy-and-bill reimbursement environments and provider-administered therapies preferred.
• Expertise in pharmaceutical compliance requirements and HIPAA regulations regarding patient confidentiality.
• Excellent interpersonal and communication skills with demonstrated ability to engage and influence diverse stakeholders.
• Demonstrated understanding of HUB services and patient support activities.
• Proven ability to manage multiple priorities in a dynamic field-based environment.
• Ability to operate as a collaborative team member working with Field Sales, Account Management, Market Access, Patient Support Services, and internal business partners.
• Must reside within the assigned territory or geography.
• Must possess a valid driver's license and meet all applicable driving requirements.
• Ability to travel approximately 50-75% based on territory requirements.

Preferred Requirements:

• Ophthalmology, retina, biologics, specialty therapeutics, or provider-administered product experience.
• Experience supporting buy-and-bill products.
• Understanding of retina practice operations, reimbursement workflows, coding and billing considerations, and provider economics.
• Experience with patient support programs, specialty pharmacies, and reimbursement HUB operations.
• Product launch experience within specialty pharmaceutical or biotechnology markets.

Required Skills:

Access & Reimbursement Education, Account Planning, Benefit Verification, Buy-and-Bill Reimbursement, Customer Focus, Healthcare Policy Knowledge, Market Access Strategy, Medicare Part B Knowledge, Patient Support Programs, Payer Coverage Analysis, Prior Authorization Processes, Reimbursement Support, Stakeholder Management, Strategic Thinking, Territory Management

Preferred Skills:

Coding & Billing Knowledge, HUB Operations, Medical Benefit Reimbursement, Ophthalmology Experience, Provider Economics, Retina Market Experience, Site-of-Care Knowledge, Specialty Therapeutics Experience

The salary range for this role is

$114,700.00 - $180,500.00

This is the lowest to highest salary we in good faith believe we would pay for this role at the time of this posting. An employee’s position within the salary range will be based on several factors including, but not limited to relevant education, qualifications, certifications, experience, skills, geographic location, government requirements, and business or organizational needs.

The successful candidate will be eligible for annual bonus and long-term incentive, if applicable.

We offer a comprehensive package of benefits. Available benefits include medical, dental, vision healthcare and other insurance benefits (for employee and family), retirement benefits, including 401(k), paid holidays, vacation, and compassionate and sick days. More information about benefits is available at https://jobs.merck.com/us/en/compensation-and-benefits.

You can apply for this role through https://jobs.merck.com/us/en (or via the Workday Jobs Hub if you are a current employee). The application deadline for this position is stated on this posting.

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