Field Reimbursement Manager

🕒 2 dias atrás

🌽 Illinois – Remoto

🌽 Illinois – Remote

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

👔 Gerente

👻 Score fantasma 10%

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Valeris

SiteLinkedInTodas as Vagas

1001 - 5000 funcionários

💊 Farmacêutico

🏥 Saúde

🤝 B2B

Pharmaceuticals • Healthcare • B2B

A Valeris é um parceiro totalmente integrado de comercialização em ciências da vida, formada pela fusão da PharmaCord e da Mercalis. A empresa oferece soluções abrangentes ao longo da cadeia de valor da saúde para ajudar as empresas de ciências da vida a levar produtos ao mercado e melhorar o acesso e a adesão dos pacientes. Valeris oferece dados e insights estratégicos, programas de suporte e acesso a pacientes e ferramentas de engajamento de prestadores de saúde, atendendo a mais de 500 clientes de ciências da vida e apoiando milhões de pacientes. Com sedes em Morrisville, Carolina do Norte, e Jeffersonville, Indiana, a Valeris se concentra em viabilizar a comercialização e serviços centrados no paciente para organizações farmacêuticas e de ciências da vida.

Descrição

• Serve as a reimbursement and access resource for healthcare providers and office staff across assigned products, disease states, and geographic areas • Provide proactive virtual reimbursement support and identify accounts benefiting from live field engagement • Conduct targeted in-person visits based on reimbursement complexity, provider education needs, access barriers, account opportunity, or business needs • Educate healthcare provider offices on payer requirements, benefit verification, prior authorization requirements, appeals processes, and access pathways • Assist provider offices with specialty pharmacy, specialty distribution, medical benefit, pharmacy benefit, and other product access models • Provide education on billing and coding requirements, claims processes, reimbursement considerations, and client-approved resources • Identify access barriers and coordinate education and resources to support timely patient access to prescribed therapy • Monitor assigned cases and reimbursement trends for proactive provider outreach and education opportunities • Support offices facing recurring reimbursement challenges, complex payer requirements, workflow barriers, or other access issues • Conduct virtual follow-up with provider offices to support continuity and efficient management of access-related needs • Collaborate with HUB services, case management, specialty pharmacies, account teams, sales teams, market access, patient services, and approved stakeholders • Identify payer, provider workflow, and access-barrier trends and communicate actionable insights to program leadership • Document all FRM activities and interactions accurately and timely in the designated CRM or technology platform • Strategically manage assigned accounts and geography, determining appropriate virtual support and live field engagement • Participate in client meetings, training programs, business reviews, field meetings, and other program activities • Maintain current knowledge of payer policies, reimbursement requirements, program resources, and healthcare access changes • Ensure activities comply with company policies, client requirements, HIPAA, applicable laws, and Compliance and Legal guidance

🎯 Requisitos

• Bachelor’s degree or equivalent combination of education and relevant professional experience • 3+ years of experience in field reimbursement, patient access, market access, reimbursement support, specialty pharmacy, HUB services, healthcare account management, or a related healthcare role • Demonstrated understanding of healthcare reimbursement and patient access processes • Experience with prior authorizations, appeals, payer requirements, specialty pharmacy processes, medical and/or pharmacy benefits, and reimbursement barriers • Strong virtual and in-person communication and presentation skills • Ability to analyze reimbursement challenges and determine the appropriate level of provider support • Ability to independently manage a broad geography and prioritize accounts based on business and access needs • Ability to work effectively across multiple products, disease states, and varying levels of reimbursement complexity • Proficiency with CRM systems, virtual communication platforms, and standard business technology • Ability to travel approximately 20–30%, including overnight travel as business needs require • Preferred: Previous FRM, reimbursement, patient access, specialty pharmacy, or HUB experience • Preferred: Experience supporting specialty or complex therapies • Preferred: Experience with both pharmacy-benefit and medical-benefit products • Preferred: Knowledge of specialty pharmacy, buy-and-bill, site-of-care, infusion, or complex distribution models • Preferred: Experience supporting multiple products or therapeutic areas • Preferred: Experience working within a hybrid field/virtual operating model • Prefer candidates who can type at least 35 words per minute with 97% accuracy • Successful completion of a background check and, depending on the position, a drug screen

🏖️ Benefícios

• Medical, dental, and vision plans, including HSA- and FSA-eligible options, with Valeris contributing toward premium costs • Telehealth and Employee Assistance Program (EAP) services • Company match on Health Savings Account contributions • Free Basic Life and AD&D coverage equal to annual earnings, with a minimum of $50,000 and a maximum of $300,000 • Company-paid Short-Term Disability coverage, with the option to purchase Long-Term Disability • 401(k) Retirement Savings Plan with 100% match on the first 5% contributed, with immediate vesting • Paid Time Off (PTO) and Sick Leave • Nine paid holidays plus two floating holidays • Opportunities for advancement and personal and professional growth • Challenging, stimulating work environment that encourages new ideas • Inclusive workplace and mission-driven culture • Background check and, depending on the position, drug screen in accordance with company standards