Field Reimbursement Team Manager

Mercalis

87d

About The Position

Mercalis is an integrated life sciences commercialization partner that provides comprehensive solutions that span the entire healthcare value chain. Backed by proven industry expertise and results-driven technology, Mercalis helps navigate the complex life sciences marketplace by providing commercialization solutions to accelerate value and enhance patient lives. Mercalis fosters a culture that encourages individuality and provides opportunities for creativity, growth, and success while fostering a team environment. We are a diversity-driven organization with an inclusive approach to delivering patient-centric solutions that eliminate barriers for patients and increase patient access to life-altering medications. The Field Reimbursement Team Manager will lead a national team of primarily virtual FRMs in support of two products, one oral specialty pharmacy medication and an injectable/infused rare disease medication. Your primary role is to train, coach, develop, and mentor the FRMs so they provide the highest level of service to the HCP offices to deliver access to therapy for their patients. This leader reports to the Sr Director, Field Reimbursement and collaborates with the Valeris operations team as well as the client’s patient services, market access and sales leadership teams.

Requirements

• Leadership experience required
• Demonstrated history of successful cross-functional collaboration balancing competing requests and priorities.
• 10+ years in the Pharmaceutical/Healthcare industry; working with hub programs, payers, specialty pharmacies, HCPs, sales, or other relevant background
• Experience with both pharmacy benefit and medical benefit (buy and bill) products
• Strong payer knowledge including public and private payers; foundational knowledge of benefit verifications and prior authorization/pre-determination requirement and knowledge of reimbursement processes
• Strong presentation skills
• Bachelor's degree required
• Valid Driver’s License
• Up to 10% of travel required

Nice To Haves

• Experience in managing access complexities associated with a new to market medication
• Dermatology experience
• Rare disease experience
• Infusion / Buy and Bill experience

Responsibilities

• Train, coach, develop, and mentor a team of FRMs.
• Utilize experience setting up an FRM team to develop and implement prioritized team processes and codify key activities.
• Provide oversight and management of team performance to meet defined objectives and KPIs.
• Coach FRM team on key job functions including program reporting, territory management, access and reimbursement issues, and Prior Authorization & Appeals support.
• Act as liaison between program management, client, and FRM team by listening to issues raised across groups, synthesizing information to find root cause, and proactively proposing or implementing solutions.
• Work with FRM team to proactively monitor and analyze program data anticipating access hurdles, identifying complex patient access issues, and equipping the FRM team to solve issues by working across the patient support program, communicating with client field team and HCP offices.
• Partner with the hub operations, client patient services, market access, and sales leadership to create and drive strategic reimbursement support approaches, resulting in increased patient and market access.
• Empower FRMs to act as reimbursement and patient support program Subject Matter Experts for HCP offices on reimbursement issues for their assigned region, utilizing all available resources, including Policy Reporter.
• Coach FRMs to educate HCP office staff on utilizing Patient Support Programs to resolve access issues per program specific operating policies.
• Identify, codify, and share FRM learnings and best practices, to enable to continued growth and improvement of the FRM team.
• Ensure the FRM team understands and operates in Compliance with HIPAA within program guidelines.
• Ensure FRMs manage cross-functional communication across internal stakeholders (hub program leadership, care coordinator, nurse educator, specialty pharmacy) and externally among a set of diverse stakeholders (physician, nurse, client’s patient services, market access and field sales team, specialty pharmacy, REMS vendor, etc.).
• Conduct regular and impromptu meetings with client patient services, market access, commercial operations, and sales leadership.
• Proactively monitor to ensure that FRMs are tracking patients submitted to the Patient Support Program for enrollment in assigned region; seek to identify any potential delays or knowledge gaps and coach the FRM to mitigate any issues.
• Work within Valeris and client designated systems to document interactions with HCPs.
• Submit scheduled reports to the Program Director regarding productivity statistics at both the team and employee level.
• Maintain team expense reports for travel and in-office meetings.

What This Job Offers

• Education Level: Bachelor's degree
• Number of Employees: 501-1,000 employees