Field Reimbursement Manager - Remote; Planes​/Lakes

Valeris is a fully integrated life sciences commercialization partner that provides comprehensive solutions that span the entire healthcare value chain. Formed by the merger of Pharma Cord and Mercalis, Valeris™ revolutionizes the path from life sciences innovation to real-life impact to build a world in which every patient gets the care they need. Valeris works on behalf of life sciences companies to improve the patient experience so that patients can access and adhere to critical medications.

Backed by proven industry expertise, a deep commitment to patient care, the latest technology, and exceptionally talented team members, Valeris provides the data and strategic insights, patient support services and healthcare provider engagement tools to help life sciences companies successfully commercialize new products. Valeris provides commercialization solutions to more than 500 life sciences customers and has provided access and affordability support to millions of patients.

The company is headquartered in Morrisville, North Carolina and Jeffersonville, Indiana. To learn more about Valeris, please visit

This position can be based in any of the following locations: NE, KS, OK, TX, AR, MO, IA, IL, IN, MI, and OH and parts of KY.

As a Field Reimbursement Manager (FRM), you will join our team on a journey to helpeliminatebarriers for patients to help increase their access to medications while working in an environment of collaboration. You will help resolve patient access issues, educate healthcare provider offices on appropriate billing and coding forclient’sproducts, and provide educational services within relevant sites of care. Additionally, the FRM role will work directly with office support staff,billing and coding staff, applicable third-party vendors(HUB, Copay Card, Patient Assistance Program (PAP)),and other important stakeholders involved with supportingpatientaccess to our client’s therapies.

The FRM will operate as the subject-matter expert on medical benefit reimbursement, access, and coverage issues including Prior Authorization and Appeals.

Responsibilities

• Solve complex patient access issues by working across the Hub, provider offices and communicating withclientfield team.
• Partner with client’sSales
  
  Team, Payer Teams,Marketing,HCPs,andtheir
  
  Specialty Pharmaciesto create and drive strategic reimbursement support approaches, resulting in increased access to therapy for individual patients.
• Educate HCP and Office Staff on Patient Support Programs, per program specific operating policies and patient journey.
• On occasion, lead HCP offices in onsite education of program business rules, payer coverage including review of miscellaneous J-codes, and other reimbursement related activities.
• Guide healthcare providers through the prior authorization and appeals process,assisting with required documentation, payer-specific requirements, and outcome communication.
• The FRM will manage daily activities that support appropriate patient access to client’s products across relevant sites of care to work as an extension of the HUB reimbursement support services offered to providers.
• Reviewappropriate billing and coding for products,assist with resolving reimbursement issues, and help ensure appropriate education to avoid future reimbursement hurdles.
• Coordinate with client’s patient support services programs representatives on patient cases and claim issues.
• Educate office staff on the use of client’s patientassistanceand reimbursement support services, including but not limited to web-based provider programs and tools, and provide information on relevant reimbursement topics related to client’s products.
• Conduct policy surveillance across regional payers to ensure appropriate coding, coverage, and payment…