Remote Field Reimbursement Manager

Valeris•Wyoming, MI

85d•Remote

About The Position

The Field Reimbursement Manager provides reactive, approved, tailored education to healthcare providers (HCPs) and their staff about financial support programs for eligible patients. The role also provides virtual education on local payer landscapes, national and regional payer policies, prior authorization criteria, letters of medical necessity, appeals templates, quantity limits, stocking information, and appropriate access pathways and processes for payers and pharmacy benefit managers (PBMs). The manager helps HCPs compliantly troubleshoot eligible patients’ claims at retail pharmacies and communicates access concerns to appropriate internal stakeholders. The position requires maintaining current knowledge of managed care, reimbursement trends, and relevant healthcare policies and regulations, including Commercial, Medicare, and Medicaid. The role works compliantly with field team representatives, follows program guidelines and HIPAA requirements, uses only approved materials and talking points, and adheres consistently to SOPs and BRDs. It also includes completing assigned tasks or projects. The work is performed in a professional office environment and routinely involves standard office equipment. Minimal travel may be needed. Valeris describes itself as an inclusive, mission-driven life sciences commercialization partner focused on improving patient access to and adherence to critical medications.

Requirements

Comply with HIPAA and program guidelines.
Follow corporate policies and procedures governing access to confidential data and complete required training on time.
Use approved materials, resources, and talking points only, and follow SOPs and BRDs consistently.

Nice To Haves

Ability to type at least 35 words per minute with 97% accuracy is preferred.
Flexibility to travel as needed is preferred.

Responsibilities

Provide reactive, approved, tailored education to HCPs and their staff about available financial support programs for eligible patients.
Educate HCPs and office support staff through virtual engagements on local payer landscapes, national and regional payer policies, prior authorization criteria, letters of medical necessity, appeals templates, quantity limits, stocking information, and payer and PBM access pathways and processes.
Assist HCPs with compliant troubleshooting of eligible patients’ claims at retail pharmacies after use of patient support financial assistance offerings.
Maintain current knowledge of managed care, reimbursement trends, and relevant healthcare policies and regulations, including Commercial, Medicare, and Medicaid.
Work compliantly with field team representatives to receive engagement requests and communicate interaction outcomes.
Model ethics and integrity to support a culture of compliance and earn the trust of external stakeholders.
Communicate access concerns and issues to appropriate internal stakeholders.
Operate in compliance with HIPAA and program guidelines.
Meet training deadlines for corporate policies and procedures governing access to confidential data.
Use approved materials, resources, and talking points only.
Follow all SOPs and BRDs consistently.
Conduct miscellaneous assigned tasks or projects.

Benefits

Medical, dental, and vision plans, including HSA- and FSA-eligible options, with Valeris contributing toward premium costs.
Telehealth and Employee Assistance Program (EAP) services.
Company match on Health Savings Account contributions.
Free basic life and AD&D coverage equal to 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) plan with 100% match on the first 5% contributed and immediate vesting.
Paid Time Off (PTO) and Sick Leave.
Nine paid holidays plus two floating holidays.
Opportunities for advancement and personal and professional growth.
A challenging, stimulating work environment that encourages new ideas.
An inclusive workplace and mission-driven culture.