Mercalis

Manager

• Educate HCPs on Patient Support Programs: Provide reactive, approved, tailored education to healthcare providers and their staff on available financial support programs for eligible patients
• Provide Reimbursement Expertise: Educate HCPs and their office support on the local payer landscape through virtual education engagements, including national and regional payer policies, prior authorization criteria including letter of medical necessity and appeals templates, quantity limits, stocking information, and appropriate access pathways and processes for payers and PBMs
• Address Access Barriers: Provide assistance to HCPs to compliantly troubleshoot claims at retail pharmacies for eligible patients who have used patient support financial assistance offerings
• Stay informed on national and regional payer policies: Maintain current knowledge of managed care, reimbursement trends, and relevant healthcare policies and regulations (e.g., Commercial, Medicare, and Medicaid)
• Work and compliantly with field team representatives to receive engagement requests and communicate outcome of interactions
• Role models ethics and integrity in the work that you do to support a culture of compliance and earn trust with external stakeholders
• Communicate access concerns and issues with appropriate internal stakeholders
• Operate in Compliance with HIPAA within program guidelines
• On time adherence to training deadlines for all corporate policies and procedures governing access to confidential data
• Ensures compliant use of approved materials, resources and talking points only
• Ensure all SOPs and BRDs are followed with consistency
• Conducts miscellaneous tasks or projects assigned

Field Reimbursement Manager