Virtual Reimbursement Manager

About the role

The Virtual Reimbursement Manager (VRM) will support multiple accounts in a specified geographic region through the access process. This role involves collaborating with internal and external stakeholders, including sales, market access, and other partners.

Responsibilities

• Support appropriate patient access to client’s products in provider offices
• Communicate payer changes to key stakeholders in a timely manner
• Educate offices on access processes, including formulary coverage/utilization management criteria, insurance forms & procedures, benefits investigation, prior authorization, and appeals
• Educate physician office staff on the use of client-specific patient support services, including web-based provider portals

Requirements

• 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 healthcare providers on client-specific patient service programs (e.g., copay, bridge, patient assistance)
• 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

• 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

Skills

• Demonstrated initiative and resourcefulness
• Results-oriented mindset

Benefits

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

Pay

• Details about pay structure are not specified

Schedule

• Details about schedule are not specified