Field Reimbursement Manager (National)

Stratis Group

114d

About The Position

Stratis Group is an independent pharmaceutical consulting firm that specializes in commercialization throughout a brand’s lifecycle, focusing on market access, patient services, field reimbursement, and data-driven analytics. In this contracted role, the Field Reimbursement Manager (FRM) is a client-facing and client-customer facing role responsible for managing a dedicated territory to support access for providers and patients. This role is highly visible within the organization and involves providing education to healthcare providers and office staff on access services and reimbursement solutions specific to a product and therapeutic area. The FRM will execute a region or territory strategic plan through partnerships with internal and external stakeholders, including call center services (HUB), sales, market access, and other matrix field partners. Responsibilities include ensuring understanding of the reimbursement process, field reimbursement services, and the client’s patient support program. The FRM will also work on patient-level reimbursement issue resolution, requiring access to and experience with patient health information (PHI). The FRM will maintain compliance and work closely within a defined set of Rules of Engagement. This role will demonstrate a compliant and consultative approach to help offices obtain insurance authorization and/or reimbursement of products for appropriate patients, directly impacting the experience for both the HCP Customer and Patient.

Requirements

• 3+ years of experience in Managed Care, Field Reimbursement, Patient Services, and/or Sales (Specialty or Biologics), or healthcare provider office practice management.
• 4-year degree in related field or equivalent experience.
• Ability to travel 3-4 days a week, with overnights and flights as needed, must reside within the territory.
• Solution-oriented mindset, strong business acumen, and strong analytic capabilities.
• Experience with specialty/biologic products and/or complex reimbursement processes.
• Demonstrated ability to educate offices on access processes and issue resolution.
• Experience educating HCPs on client-specific Patient Service programs (i.e. copay, nurse education, bridge, patient assistance, etc.).
• Experience delivering educational presentations in person and/or via technology platforms such as Zoom, Webex, and/or Teams.
• Advanced knowledge of medical insurance terminology.
• Knowledge of Centers of Medicare & Medicaid Services (CMS) policies and processes with expertise in Medicare (Part B – for buy & bill products and Part D for Pharmacy products).
• Ability to manage ambiguity and problem solve.
• Prepare and submit appropriate expense reports in a timely fashion.
• Valid Driver’s License.

Responsibilities

• Manage daily activities that support appropriate patient access to client’s products in provider offices.
• Act as a liaison to other patient assistance and access support services offered by clients (i.e. HUB, Call Center, Specialty Pharmacy Services).
• Provide in-person customer visits as an extension of client’s HUB.
• Participate in client meetings and regularly scheduled team meetings and calls.
• Input call activity into customer CRM as appropriate.
• Serve as payer expert for defined geography and communicate payer changes to key stakeholders in a timely manner.
• Provide office education and awareness during the entire access process, including formulary coverage/utilization management criteria, insurance forms & procedures, benefits investigation, prior authorization, appeal, and/or claims resolution.
• Educate offices using approved educational materials provided by the client.
• Review specific patient case information in a compliant manner as defined by the client.
• Educate physician office staff on the use of client’s patient support services, including web-based provider portals.

What This Job Offers

• Education Level: Bachelor's degree
• Number of Employees: 11-50 employees