Hybrid Virtual Access and Reimbursement Manager educating healthcare providers on patient access and reimbursement. Requires relevant experience and a strong understanding of payer landscape.
Responsibilities
Engage healthcare providers and appropriate office staff to educate on access to prescribed treatments within the specialty pharmacy and HUB channel, including addressing questions about initial access, insurance approval and reauthorizations pertaining to the initiation of product.
Educate HCP office staff about prior authorization & appeals process, how to access related forms, and high-level information about submission procedures and reauthorization requirements.
Work compliantly and proactively to identify and resolve patient access and reimbursement issues, within assigned geography.
Provide appropriate factual process information to HCP office utilizing Personal Health Information (PHI), with appropriate patient consent.
Serve as reimbursement expert for patient support services team for assigned geography/plans.
Utilize approved resources and call guides/FAQs to provide education and answer questions as needed.
Conduct ongoing payer policy reviews and contribute local, regional and national policy insights to Field Access Managers and client leadership.
Virtually manage assigned accounts and align with Field Access and Reimbursement team, sales teams as well as specialty pharmacy and HUB team on ongoing support needs.
Document call details with attention to data integrity to ensure compliance with program policies and business rules.
Maintain confidentiality of Patient Health Information (PHI) and act in compliance with all laws, regulations, and company policies.
Triage appropriate escalations to the Field Access Manager team in accordance with the program design and business rules.
Requirements
BS/BA Degree Required
Proven success operating in a virtual environment
3+ years of relevant experience in – reimbursement and patient access, market access, specialty pharmacy, or physician/system account management.
Experience engaging HCP staff in a support role to educate on access pathways and product requirements.
Experience navigating payer reimbursement process for oral medications.
Experience with specialty products acquired through specialty pharmacy networks.
Patient-centric and service-oriented mindset, with a high degree of emotional intelligence and empathy.
Exceptional customer and patient engagement skills, attention to detail, and the ability to think comprehensively is a must.
Exemplary interpersonal and listening skills.
Strong communication (written and verbal), and presentation skills.
High enthusiasm with a drive to success within a team – demonstrated ability to reach common goals in collaboration with multiple therapeutic specialists, sales leadership, market access, and patient support services colleagues.
Highly organized with excellent attention to detail and the ability to multi-task in engaging both patients and providers.
Benefits
Competitive compensation
Excellent Benefits – accrued time off, medical, dental, vision, 401k, disability & life insurance, paid maternity and bonding time benefits, employee discounts/promotions
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