Remote Field Reimbursement Manager

About the role

The Remote Field Reimbursement Manager (FRM) plays a crucial role in supporting patient access to critical therapies by addressing access challenges through virtual education of healthcare providers and support staff.

Responsibilities

• Educate HCPs on Patient Support Programs
• Provide reactive, approved, tailored education to healthcare providers and their staff on available financial support programs for eligible patients
• Educate HCPs and their office support on the local payer landscape through virtual education engagements, including national and regional payer policies, prior authorization criteria including letter of medical necessity and appeals templates, quantity limits, stocking information, and appropriate access pathways and processes for payers and PBMs
• Address Access Barriers
• Provide assistance to HCPs to compliantly troubleshoot claims at retail pharmacies for eligible patients who have used patient support financial assistance offerings
• Stay informed on national and regional payer policies
• Maintain current knowledge of managed care, reimbursement trends, and relevant healthcare policies and regulations (e.g., Commercial, Medicare, and Medicaid)
• Work and comply with field team representatives to receive engagement requests and communicate outcome of interactions
• Role model ethics and integrity in the work that you do to support a culture of compliance and earn trust with external stakeholders
• Communicate access concerns and issues with appropriate internal stakeholders
• Operate in compliance with HIPAA within program guidelines
• On time adherence to training deadlines for all corporate policies and procedures governing access to confidential data
• Ensures compliant use of approved materials, resources and talking points only
• Conducts miscellaneous tasks or projects assigned

Qualifications

• Bachelor’s degree
• 5+ years of experience in Case Management Reimbursement Experience; product launch experience is highly desired
• 5+ years in the Pharma/Healthcare industry; working with Hubs, Payers, HCP or related area
• Advanced understanding of the U.S. reimbursement landscape, including commercial and government payers, patient access support programs and prior authorization requirements
• Demonstrated ability to conduct virtual access support and education
• Excellent written and verbal communication skills, and presentation expertise to effectively educate diverse stakeholders
• Proven ability to seamlessly address and resolve access barriers to enable patient access and affordability to prescribed therapies
• Highly competent in a multitude of IT capabilities to support the business needs including Veeva CRM
• Adequate understanding of and strict adherence to all federal and state compliance guidelines and regulations, including HIPAA

Benefits

Valeris offers a comprehensive benefits package including medical, dental, and vision plans, additional health support, free basic life and AD&D coverage, company match on Health Savings Account contributions, company-paid Short-Term Disability coverage, Paid Time Off (PTO) and Sick Leave, and opportunities for advancement in a supportive and inclusive culture.