Field Reimbursement Manager

This is a fully remote position, open to applicants in California, +4 more states.

📋 Description

• Educate healthcare providers and their staff about approved financial assistance programs available for eligible patients.

• Deliver virtual training on local, national, and regional payer landscapes, which includes payer policies, prior authorization criteria, letters of medical necessity, appeals templates, quantity limits, stocking information, and access pathways.

• Compliantly assist in troubleshooting claims for eligible patients at retail pharmacies when financial assistance options are utilized.

• Stay updated on managed care, reimbursement trends, and healthcare policies and regulations, encompassing Commercial, Medicare, and Medicaid.

• Collaborate compliantly with field team representatives to receive engagement requests and relay interaction outcomes.

• Address access concerns and issues with the relevant internal stakeholders.

• Operate in accordance with HIPAA and program guidelines.

• Meet training deadlines for corporate policies and procedures that govern confidential data.

• Utilize only approved materials, resources, and talking points.

• Consistently follow all SOPs and BRDs.

• Perform other assigned tasks or projects as necessary.

⛳️ Requirements

• Capability to educate healthcare providers and office staff regarding patient support and financial assistance programs.

• Expertise in reimbursement covering commercial, Medicare, and Medicaid payer policies.

• Familiarity with prior authorization criteria, letters of medical necessity, appeals templates, quantity limits, stocking information, and payer/PBM access pathways.

• Ability to compliantly troubleshoot claims at retail pharmacies.

• Current understanding of managed care, reimbursement trends, healthcare policies, and regulations.

• Capacity to work compliantly with field team representatives and internal stakeholders.

• Knowledge of and ability to adhere to HIPAA and program guidelines.

• Commitment to corporate policies, procedures, SOPs, and BRDs.

• Compliant use of only approved materials, resources, and talking points.

• Preferred typing speed of at least 35 words per minute with 97% accuracy.

• Preferred flexibility to travel as needed.

• Successful completion of a background check and, depending on the position, a drug screen.

🏝️ Benefits

• Medical, dental, and vision plans, including HSA- and FSA-eligible options, with Valeris contributing toward premium costs.

• Telehealth services and Employee Assistance Program (EAP) services.

• Company match on Health Savings Account contributions.

• Complimentary 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 an option to purchase Long-Term Disability.

• 401(k) Retirement Savings Plan with a 100% match on the first 5% contributed, featuring immediate vesting.

• Paid Time Off (PTO) and Sick Leave.

• Nine paid holidays plus two floating holidays.

• Opportunities for advancement and personal and professional growth.

• Engaging and stimulating work environment that fosters new ideas.

• Inclusive workplace and mission-driven culture.

• Background check and, depending on the position, drug screen required as a condition of employment.