Mercalis

Field Reimbursement Manager

Mercalis

full-time

Posted on:

Location Type: Remote

Location: North Carolina • United States

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About the role

  • 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

Requirements

  • Bachelor’s degree
  • 5+ experience in Case Management Reimbursement Experience; product launch experience is highly desired
  • 5+ in the Pharma/Healthcare industry; working with Hubs, Payers, HCP or related area
  • Advanced understanding of the U.S. reimbursement landscape, including commercial and government payers, patient access support programs and prior authorization requirements
  • Demonstrated ability to conduct virtual access support and education
  • Excellent written and verbal communication skills, and presentation expertise to effectively educate diverse stakeholders
  • Proven ability to seamlessly address and resolve access barriers to enable patient access and affordability to prescribed therapies
  • Highly competent in a multitude of IT capabilities to support the business needs including Veeva CRM
  • A deep understanding of and strict adherence to all federal and state compliance guidelines and regulations, including HIPAA
  • Infrequent travel may be required for various national meetings, training programs and POAs
  • Valid driver’s license required for travel
  • Prefer candidates who can type at least 35 words per minute with 97% accuracy
Benefits
  • Medical, dental, and vision plans, including HSA- and FSA-eligible options, with Valeris contributing toward premium costs
  • Additional health support, including telehealth and Employee Assistance Program (EAP) services
  • Company match on Health Savings Account contributions
  • Free Basic Life and AD&D coverage equal to your 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% you contribute, with immediate vesting
  • Paid Time Off (PTO) and Sick Leave to support work-life balance
  • Team members receive nine paid holidays plus two floating holidays
  • Opportunities for advancement in a company that supports personal and professional growth
  • A challenging, stimulating work environment that encourages new ideas
  • Work for a company that values diversity and makes deliberate efforts to create an inclusive workplace
  • A mission-driven, inclusive culture where your work makes a meaningful impact
Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools
Case Management Reimbursement ExperienceU.S. reimbursement landscapepatient access support programsprior authorization requirementsvirtual access supportpresentation expertiseIT capabilitiestyping skills
Soft Skills
excellent written communicationexcellent verbal communicationproblem-solvingability to educate stakeholdersethics and integrityability to address access barriersorganizational skills
Certifications
Bachelor’s degreevalid driver’s license