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Freelance Remote Prior Authorization Jobs in Colorado

Valeris

Remote Field Reimbursement Manager

Denver, CO · Remote

As a Remote Field Reimbursement Manager you will help support patient access to critical therapies ... prior authorizations, appeals processes, and patient support financial assistance offerings. This ...

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Remote Field Reimbursement Manager

Denver, CO • Remote

Valeris
See more jobs at Valerisexternal

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 29 days ago

Job description

*** Seeking candidates that reside in the West and Mid-West Regions of the United States ***
Valeris is a fully integrated life sciences commercialization partner that provides comprehensive solutions that span the entire healthcare value chain. Formed by the merger of PharmaCord and Mercalis, Valeris™ revolutionizes the path from life sciences innovation to real-life impact to build a world in which every patient gets the care they need. Valeris works on behalf of life sciences companies to improve the patient experience so that patients can access and adhere to critical medications. Backed by proven industry expertise, a deep commitment to patient care, the latest technology, and exceptionally talented team members, Valeris provides the data and strategic insights, patient support services and healthcare provider engagement tools to help life sciences companies successfully commercialize new products. Valeris provides commercialization solutions to more than 500 life sciences customers and has provided access and affordability support to millions of patients. The company is headquartered in Morrisville, North Carolina and Jeffersonville, Indiana. To learn more about Valeris, please visit www.valeris.com.
As a Remote Field Reimbursement Manager you will help support patient access to critical therapies by resolving access challenges through virtual education of healthcare provider (HCP) and support staff at sites of care. The FRM will be HCP-facing and serve as the subject-matter expert on regional payer access, prior authorizations, appeals processes, and patient support financial assistance offerings. This role focuses on ensuring timely and effective patient access and is strictly non-promotional and does not involve sales or the provision of clinical care/medical advice.
Responsibilities
  • Educate HCPs on Patient Support Programs: Provide reactive, approved, tailored education to healthcare providers and their staff on available financial support programs for eligible patients
  • Provide Reimbursement Expertise: Educate HCPs and their office support on the local payer landscape through virtual education engagements, including national and regional payer policies, prior authorization criteria including letter of medical necessity and appeals templates, quantity limits, stocking information, and appropriate access pathways and processes for payers and PBMs
  • Address Access Barriers: Provide assistance to HCPs to compliantly troubleshoot claims at retail pharmacies for eligible patients who have used patient support financial assistance offerings
  • Stay informed on national and regional payer policies: Maintain current knowledge of managed care, reimbursement trends, and relevant healthcare policies and regulations (e.g., Commercial, Medicare, and Medicaid”.
  • Work and compliantly with field team representatives to receive engagement requests and communicate outcome of interactions Role models ethics and integrity in the work that you do to support a culture of compliance and earn trust with external stakeholders
  • Communicate access concerns and issues with appropriate internal stakeholders
  • Operate in Compliance with HIPAA within program guidelines
  • On time adherence to training deadlines for all corporate policies and procedures governing access to confidential data
  • Ensures compliant use of approved materials, resources and talking points only
  • Ensure all SOPs and BRDs are followed with consistency
  • Conducts miscellaneous tasks or projects assigned
Qualifications:
  • Bachelor’s degree
  • 5+ experience in Case Management Reimbursement Experience; product launch experience is highly desired
  • 5+ in the Pharma/Healthcare industry; working with Hubs, Payers, HCP or related area
  • Advanced understanding of the U.S. reimbursement landscape, including commercial and government payers, patient access support programs and prior authorization requirements
  • Demonstrated ability to conduct virtual access support and education
  • Excellent written and verbal communication skills, and presentation expertise to effectively educate diverse stakeholders
  • Proven ability to seamlessly address and resolve access barriers to enable patient access and affordability to prescribed therapies
  • Highly competent in a multitude of IT capabilities to support the business needs including Veeva CRM
  • A deep understanding of and strict adherence to all federal and state compliance guidelines and regulations, including HIPAA
Travel Requirements:
  • Infrequent travel may be required for various national meetings, training programs and POAs
  • Valid driver’s license required for travel
Physical Demands amp; Work Environment
While performing the duties of this job, the employee is regularly required to talk or hear. The employee is frequently required to sit for long periods of time, use hands to type, handle or feel; and reach with hands and arms. Prefer candidates who can type at least 35 words per minute with 97% accuracy.
Although very minimal, flexibility to travel as needed is preferred.
This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, etc.
Why Work for Valeris?
We’re committed to supporting the well-being and success of our team members. As part of our organization, full-time employees can expect:
  • Medical, dental, and vision plans, including HSA- and FSA-eligible options, with Valeris contributing toward premium costs
  • Additional health support, including telehealth and Employee Assistance Program (EAP) services
  • Company match on Health Savings Account contributions
  • Free Basic Life and AD amp;D coverage equal to your 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% you contribute, with immediate vesting
  • Paid Time Off (PTO) and Sick Leave to support work-life balance
  • Team members receive nine paid holidays plus two floating holidays
  • Opportunities for advancement in a company that supports personal and professional growth
  • A challenging, stimulating work environment that encourages new ideas
  • Work for a company that values diversity and makes deliberate efforts to create an inclusive workplace
  • A mission-driven, inclusive culture where your work makes a meaningful impact
Any offer of employment is contingent upon the successful completion of a background check and, depending on the position, a drug screen in accordance with company standards. Please note that this job description is not intended to be an exhaustive list of all duties, responsibilities, or activities associated with the position. Responsibilities and tasks may be modified at any time, with or without notice.
Our Commitment to Equal Opportunity
At Valeris, we don’t just accept difference – we celebrate it, support it and we thrive on it for the benefit of our employees, our products and our community. Valeris is proud to be an equal opportunity employer.
#INDFRM

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