Field Reimbursement Manager

🕒 vor 1 Monat

🏄 California, Kansas, +3 weitere Bundesländer – Remote

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⏰ Vollzeit

🟡 Mittelstufe

🟠 Senior

👔 Manager

👻 Geisterscore 24%

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🗣️🇺🇸🇬🇧 Englisch erforderlich

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Valeris

1001 - 5000 Mitarbeiter

💊 Pharmazie

🏥 Gesundheitswesen

🤝 B2B

Pharmaceuticals • Healthcare • B2B

Valeris ist ein vollständig integrierter Vermarktungspartner für die Life-Sciences-Branche, der durch die Fusion von PharmaCord und Mercalis entstanden ist. Das Unternehmen bietet umfassende Lösungen entlang der gesamten Wertschöpfungskette im Gesundheitswesen, um Life-Sciences-Unternehmen dabei zu unterstützen, Produkte auf den Markt zu bringen und den Zugang von Patienten und deren Therapietreue zu verbessern. Valeris bietet Daten- und Strategieeinblicke, Patientenunterstützung und Zugangsprogramme sowie Instrumente zur Einbindung von Gesundheitsdienstleistern. Das Unternehmen betreut über 500 Kunden aus der Life-Sciences-Branche und unterstützt Millionen von Patienten. Mit Hauptsitz in Morrisville, North Carolina und Jeffersonville, Indiana, konzentriert sich Valeris auf die Vermarktung und patientenorientierte Dienstleistungen für pharmazeutische und Life-Sciences-Organisationen.

Beschreibung

• Educate healthcare providers and their staff on approved patient support financial assistance programs for eligible patients • Provide virtual education on local, national, and regional payer landscapes, including payer policies, prior authorization criteria, letters of medical necessity, appeals templates, quantity limits, stocking information, and access pathways • Compliantly troubleshoot eligible patients’ claims at retail pharmacies when financial assistance offerings have been used • Maintain current knowledge of managed care, reimbursement trends, and healthcare policies and regulations, including Commercial, Medicare, and Medicaid • Work compliantly with field team representatives to receive engagement requests and communicate interaction outcomes • Communicate access concerns and issues to appropriate internal stakeholders • Operate within HIPAA and program guidelines • Meet training deadlines for corporate policies and procedures governing confidential data • Use only approved materials, resources, and talking points • Follow all SOPs and BRDs consistently • Conduct miscellaneous assigned tasks or projects

🎯 Anforderungen

• Ability to educate healthcare providers and office staff on patient support and financial assistance programs • Reimbursement expertise covering commercial, Medicare, and Medicaid payer policies • Knowledge of prior authorization criteria, letters of medical necessity, appeals templates, quantity limits, stocking information, and payer/PBM access pathways • Ability to compliantly troubleshoot retail pharmacy claims • Current knowledge of managed care, reimbursement trends, healthcare policies, and regulations • Ability to work compliantly with field team representatives and internal stakeholders • Knowledge of and ability to operate within HIPAA and program guidelines • Adherence to corporate policies, procedures, SOPs, and BRDs • Compliant use of approved materials, resources, and talking points only • Ability to type at least 35 words per minute with 97% accuracy preferred • Flexibility to travel as needed preferred • Successful completion of a background check and, depending on the position, a drug screen

🏖️ Vorteile

• 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 required as a condition of employment

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