Field Reimbursement Manager

🕒 Outubro 28

🌵 Arizona, New Mexico, +2 estados a mais – Remoto

🌵 Arizona – Remote 🌶️ New Mexico – Remote 🌪️ Oklahoma – Remote 🤠 Texas – Remote

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

👔 Gerente

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• Aberta há 14 dias.
• As vagas desta empresa costumam ser preenchidas em 21 dias.
• Sem salário divulgado.

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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

• Resolve complex patient access issues across the Hub and provider offices while communicating with the client field team • Partner with Sales, Payer Teams, Marketing, HCPs, and Specialty Pharmacies to develop strategic reimbursement support approaches • Educate HCPs and office staff on Patient Support Programs and patient journeys • Lead onsite education for HCP offices on program business rules, payer coverage, miscellaneous J-codes, and reimbursement activities • Guide providers through prior authorization and appeals processes, including documentation, payer requirements, and outcome communication • Manage daily activities supporting patient access to client products across relevant sites of care • Review billing and coding, resolve reimbursement issues, and prevent future reimbursement hurdles • Coordinate with patient support services representatives on patient cases and claim issues • Educate office staff on patient assistance and reimbursement support services, including web-based provider programs and tools • Conduct regional payer policy surveillance for coding, coverage, and payment • Educate providers on local payer coverage and reimbursement trends through educational programs • Lead sales training related to product reimbursement as appropriate • Communicate reimbursement concerns to internal stakeholders, including Sales and Managed Markets • Monitor national and regional payer trends and changes • Collaborate with Managed Markets to escalate potential payer issues • Operate in compliance with HIPAA and program guidelines • Complete training deadlines for corporate policies governing confidential data • Follow all SOPs and BRDs consistently

🎯 Requisitos

• Associate's degree or higher in a related field or equivalent market experience • 3+ years in the Pharma/Healthcare industry, working with specialty products, Hubs, Payers, HCPs, or a related area • Direct experience with specialty dermatology products preferred • Specific practice management, billing, and/or coding experience for drugs, biologicals, or devices • General payer policy knowledge, including public and private payers • Foundational knowledge of medical benefit verifications and prior authorization/pre-determination requirements • Knowledge of reimbursement processes within various sites of care • Ability to conduct virtual and field-based reimbursement support and education • Experience with prior authorizations, reimbursement billing, coding, and appeals processes • Knowledge of commercial payer, Medicare, and Medicaid structures, systems, and reimbursement processes • Strong stakeholder engagement and communication skills • Valid Driver’s License when travel is required • Ability to type at least 35 words per minute with 97% accuracy preferred • Flexibility to travel as needed preferred • Up to 10% travel may be required, plus additional travel for national meetings, training programs, and POAs • 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 encouraging new ideas • Inclusive workplace and mission-driven culture • Background check and, depending on the position, drug screen in accordance with company standards

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