Regional Clinical Manager
PM Pediatric Care
Access & Reimbursement Manager, CV
Kerr Dental
full-time
Posted on:
Location: California • 🇺🇸 United States
Visit company websiteSalary
💰 $138,600 - $257,400 per year
Job Level
Mid-LevelSenior
Tech Stack
SFDC
About the role
- Field-based Access and Reimbursement Manager providing in-person (or virtual) education to accounts on access and reimbursement topics
- Serve as key contact and local market expert on payer policy coverage, acquisition pathways, billing/coding, claims processing, reimbursement, and manufacturer support program integration
- Coordinate and communicate cross-functionally with Patient Support Center, Sales, Marketing, Market Access, and other teams
- Analyze account reimbursement issues and identify trends to support patient pull-through and local coverage decisions
- Establish preferred acquisition pathways and educate on buy-and-bill end-to-end processes and alternative channels (white bagging, clear bagging, brown bagging)
- Interface with Patient Support Center on case management, tracking, issue resolution, and reimbursement support
- Handle Patient Identifiable Information appropriately and ensure HIPAA compliance
- Identify and report adverse events as required
- Accountable for meeting corporate objectives and customer satisfaction metrics related to access support
Requirements
- Bachelor’s Degree required; Advanced degree preferred
- Minimum three to five years' experience in public or private third-party Reimbursement or pharmaceutical industry (minimum 36 months)
- Specialty pharmacy experience required (specialty pharmacy products, buy-and-bill)
- Experience with coding, billing and in-office support programs
- Knowledge of CMS policies and Medicare Parts B and D a plus
- Knowledge of Managed Care, Government, Federal payer sectors, and Integrated Delivery Networks a plus
- Prior account management experience or experience with complex accounts
- Ability to analyze problems and offer solutions
- Ability to operate as a team player and collaborate with sales and internal colleagues
- Excellent presentation skills and ability to educate providers and staff
- Project management skills and ability to work independently
- Above average computer skills: PowerPoint, Excel, Word, CRM (Salesforce.com)
- Understanding of patient privacy laws including HIPAA and similar state laws
- Ability to travel extensively (at least 50%) and cover large multistate geography territories
- Must live within assigned territory and have a fully valid and unrestricted driver’s license
- Good driving record and ability to schedule work-related travel
