Field Reimbursement Manager

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🏄 California, Kansas, +3 more states – Remote

🏄 California – Remote 🌪️ Kansas – Remote 🏰 Missouri – Remote ☕ Washington – Remote 🦬 Wyoming – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

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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

• 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

🎯 Requirements

• 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

🏖️ 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 required as a condition of employment