Field Reimbursement Manager
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Job Description
Field Reimbursement Manager supporting provider reimbursement and patient access. Valeris commercializes life sciences products through healthcare access and patient support solutions.
Responsibilities:
- Serve as a reimbursement and access resource for healthcare providers and office staff across assigned products, disease states, and geographic areas
- Provide proactive virtual reimbursement support and identify accounts benefiting from live field engagement
- Conduct targeted in-person visits based on reimbursement complexity, provider education needs, access barriers, account opportunity, or business needs
- Educate healthcare provider offices on payer requirements, benefit verification, prior authorization requirements, appeals processes, and access pathways
- Assist provider offices with specialty pharmacy, specialty distribution, medical benefit, pharmacy benefit, and other product access models
- Provide education on billing and coding requirements, claims processes, reimbursement considerations, and client-approved resources
- Identify access barriers and coordinate education and resources to support timely patient access to prescribed therapy
- Monitor assigned cases and reimbursement trends for proactive provider outreach and education opportunities
- Support offices facing recurring reimbursement challenges, complex payer requirements, workflow barriers, or other access issues
- Conduct virtual follow-up with provider offices to support continuity and efficient management of access-related needs
- Collaborate with HUB services, case management, specialty pharmacies, account teams, sales teams, market access, patient services, and approved stakeholders
- Identify payer, provider workflow, and access-barrier trends and communicate actionable insights to program leadership
- Document all FRM activities and interactions accurately and timely in the designated CRM or technology platform
- Strategically manage assigned accounts and geography, determining appropriate virtual support and live field engagement
- Participate in client meetings, training programs, business reviews, field meetings, and other program activities
- Maintain current knowledge of payer policies, reimbursement requirements, program resources, and healthcare access changes
- Ensure activities comply with company policies, client requirements, HIPAA, applicable laws, and Compliance and Legal guidance
Requirements:
- Bachelor’s degree or equivalent combination of education and relevant professional experience
- 3+ years of experience in field reimbursement, patient access, market access, reimbursement support, specialty pharmacy, HUB services, healthcare account management, or a related healthcare role
- Demonstrated 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
- Strong virtual and in-person communication and presentation skills
- Ability to analyze reimbursement challenges and determine the appropriate level of provider support
- Ability to independently manage a broad geography and prioritize accounts based on business and access needs
- Ability to work effectively across multiple products, disease states, and varying levels of reimbursement complexity
- Proficiency with CRM systems, virtual communication platforms, and standard business technology
- Ability to travel approximately 20–30%, including overnight travel as business needs require
- Preferred: Previous FRM, reimbursement, patient access, specialty pharmacy, or HUB experience
- 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
- Prefer candidates who can type at least 35 words per minute with 97% accuracy
- 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 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) 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
- Challenging, stimulating work environment that encourages new ideas
- Inclusive workplace and mission-driven culture
- Background check and, depending on the position, drug screen in accordance with company standards
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