Field Reimbursement Manager

This is a fully remote position, open to applicants in Illinois.

📋 Description

• Act as a reimbursement and access resource for healthcare providers and office staff across designated products, disease states, and geographic regions.

• Offer proactive virtual reimbursement assistance and pinpoint accounts that could benefit from live field engagement.

• Execute focused in-person visits based on factors like reimbursement complexity, provider education needs, access obstacles, account potential, or business requirements.

• Inform healthcare provider offices about payer requirements, benefit verification, prior authorization needs, appeals processes, and access pathways.

• Aid provider offices with specialty pharmacy, specialty distribution, medical benefit, pharmacy benefit, and various product access models.

• Provide instruction on billing and coding requirements, claims processes, reimbursement considerations, and client-approved resources.

• Identify access barriers and coordinate education and resources to facilitate timely patient access to prescribed therapy.

• Monitor assigned cases and reimbursement trends for proactive outreach and educational opportunities for providers.

• Assist offices experiencing recurring reimbursement challenges, complex payer requirements, workflow hurdles, or other access issues.

• Conduct virtual follow-ups with provider offices to ensure continuity and effective management of access-related needs.

• Collaborate with HUB services, case management, specialty pharmacies, account teams, sales teams, market access, patient services, and approved stakeholders.

• Recognize trends in payer, provider workflow, and access barriers, and communicate actionable insights to program leadership.

• Accurately document all FRM activities and interactions in the designated CRM or technology platform in a timely manner.

• Strategically manage assigned accounts and geographical areas, determining the appropriate level of virtual support and live field engagement.

• Engage in client meetings, training programs, business reviews, field meetings, and other program-related activities.

• Stay updated on payer policies, reimbursement requirements, program resources, and changes in healthcare access.

• Ensure that all activities comply with company policies, client requirements, HIPAA, relevant laws, and Compliance and Legal guidance.

⛳️ Requirements

• Bachelor’s degree or an equivalent combination of education and relevant professional experience.

• Over 3 years of experience in field reimbursement, patient access, market access, reimbursement support, specialty pharmacy, HUB services, healthcare account management, or a related healthcare position.

• Proven understanding of healthcare reimbursement and patient access processes.

• Experience with prior authorizations, appeals, payer requirements, specialty pharmacy processes, medical and/or pharmacy benefits, and reimbursement barriers.

• Excellent virtual and in-person communication and presentation abilities.

• Capability to analyze reimbursement challenges and determine the necessary level of provider support.

• Ability to independently manage a wide geographical area and prioritize accounts based on business and access needs.

• Proficiency in working across multiple products, disease states, and varying levels of reimbursement complexity.

• Familiarity with CRM systems, virtual communication platforms, and standard business technology.

• Willingness to travel approximately 20–30%, including overnight travel as required by business needs.

• Preferred: Prior experience in FRM, reimbursement, patient access, specialty pharmacy, or HUB services.

• Preferred: Experience supporting specialty or complex therapies.

• Preferred: Experience with both pharmacy-benefit and medical-benefit products.

• Preferred: Knowledge of specialty pharmacy, buy-and-bill, site-of-care, infusion, or complex distribution models.

• Preferred: Experience supporting multiple products or therapeutic areas.

• Preferred: Experience working within a hybrid field/virtual operating model.

• Candidates who can type at least 35 words per minute with 97% accuracy are preferred.

• Successful completion of a background check and, if applicable, a drug screen is required.

🏝️ 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.

• 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 the option to purchase Long-Term Disability.

• 401(k) Retirement Savings Plan with 100% match on the first 5% contributed, with 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, stimulating work environment that encourages innovative ideas.

• Inclusive workplace and mission-driven culture.

• Background check and, if applicable, drug screen in accordance with company standards.