Field Reimbursement Manager

🔥 0 minutes ago

🌽 Illinois – Remote

🌽 Illinois – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

👻 Ghost score 10%

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Valeris

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

💊 Pharmaceuticals

🏥 Healthcare

🤝 B2B

Pharmaceuticals • Healthcare • B2B

Valeris is a fully integrated life sciences commercialization partner formed by the merger of PharmaCord and Mercalis. The company provides comprehensive solutions across the healthcare value chain to help life sciences companies bring products to market and improve patient access and adherence. Valeris offers data and strategic insights, patient support and access programs, and healthcare provider engagement tools, serving over 500 life sciences customers and supporting millions of patients. Headquartered in Morrisville, North Carolina and Jeffersonville, Indiana, Valeris focuses on enabling commercialization and patient-centric services for pharmaceutical and life sciences organizations.

📋 Description

• 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

🎯 Requirements

• 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

🏖️ Benefits

• 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