Field Reimbursement Manager

🔥 2 minutes ago

🌲 North Carolina, Maryland, +3 more states – Remote

🌲 North Carolina – Remote 🦀 Maryland – Remote 🌴 South Carolina – Remote ⚔️ Virginia – Remote ⛰️ West Virginia – 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

• 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, operating policies, and patient journeys • Lead onsite education for HCP offices on program rules, payer coverage, 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 provide education to prevent future 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 policy surveillance across regional payers 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 follow program guidelines, SOPs, and BRDs • Complete training deadlines for corporate policies governing confidential data

🎯 Requirements

• Associate's degree or higher in a related field or equivalent market experience • 3+ years in the pharmaceutical/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 • 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, mission-driven culture • Up to 10% travel and additional travel for national meetings, training programs, and POAs