Virtual Reimbursement Manager

About the role

The Virtual Reimbursement Manager (VRM) will support multiple accounts in a specified geographic region through the access process. Responsibilities include ensuring understanding of coverage, access process, and reimbursement services.

Responsibilities

• Manage daily activities that support appropriate patient access to our client’s products in the provider offices
• Serve as payer expert for defined geography and communicate payer changes to key stakeholders
• Offer office education during the entire access process, including formulary coverage/utilization management criteria, insurance forms & procedures, benefits investigation, prior authorization, and appeals
• Educate offices using approved materials provided by the client
• Educate physician office staff on the use of our client’s patient support services, including web-based provider portals

Requirements

• Demonstrated initiative, resourcefulness, and a results-oriented mindset
• Bachelor’s Degree
• Minimum two years of experience in public or private third-party reimbursement or access arena or pharmaceutical industry in managed care or clinical support
• Demonstrated understanding of access, coverage, and reimbursement issues in the retail channel, including commercial and federal health care program utilization management tools such as prior authorization, step edits, and denials
• Experience educating HCPs on client-specific Patient Service programs (i.e., copay, bridge, patient assistance, etc.)
• Experience delivering educational presentations
• Advanced knowledge of medical insurance terminology
• Knowledge of Centers of Medicare & Medicaid Services (CMS) policies and processes with expertise in Medicare Parts B & D

Qualifications

• Knowledge of Centers of Medicare & Medicaid Services (CMS) policies and processes with expertise in Medicare Parts B & D

Skills

• Demonstrated initiative, resourcefulness, and a results-oriented mindset
• Bachelor’s Degree
• Minimum two years of experience in public or private third-party reimbursement or access arena or pharmaceutical industry in managed care or clinical support
• Demonstrated understanding of access, coverage, and reimbursement issues in the retail channel, including commercial and federal health care program utilization management tools such as prior authorization, step edits, and denials
• Experience educating HCPs on client-specific Patient Service programs (i.e., copay, bridge, patient assistance, etc.)
• Experience delivering educational presentations
• Advanced knowledge of medical insurance terminology
• Knowledge of Centers of Medicare & Medicaid Services (CMS) policies and processes with expertise in Medicare Parts B & D

Benefits

• Competitive compensation package
• Health benefits to include Medical, Dental, and Vision
• Company match 401k
• Flexible paid time off (PTO) and sick time

Pay

• Details TBD

Schedule

• Details TBD