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Summary / Scope:
Stratis Group is an independent pharmaceutical consulting firm that specializes in commercialization throughout a brand's lifecycle, our core passions include: market access, patient services, field reimbursement, and data-driven analytics.
In this contracted role, the Vaccine Access and Reimbursement Manager (VARM) is a client-facing and client-customer facing role that will be responsible for managing a dedicated territory to support access for provider and patients. This role will be highly visible within the organization and responsible for providing education to healthcare providers and office staff on access services and reimbursement solutions specific to a product and therapeutic area.
The VARM will execute a region or territory strategic plan through partnership with internal and external stakeholders, which may include call center services (HUB), sales, market access, and/or other matrix field partners. Responsibilities include ensuring understanding of the reimbursement process, field reimbursement services, and client's patient support program. The VARM will also work on patient-level reimbursement issue resolution and thus will need access to and have had experience with patient health information (PHI). The VARM will abide in a compliant manner and will work closely within a defined set Rules of Engagement.
In this role, the VARM will demonstrate a compliant and consultative approach to help offices obtain insurance authorization and/or reimbursement of products for appropriate patients. The VARM will have a direct impact on providing a positive experience for both the HCP Customer and Patient.
Key Responsibilities
Provider & Office Education
• Educate healthcare providers and office staff on payer coverage, coding, and payment policies for a vaccine portfolio
• Utilizing approved client materials, provide product access and reimbursement expertise tailored to office needs.
Patient Access Support
• Help offices understand and utilize Patient Support Programs that facilitate access for appropriate patients.
• Analyze reimbursement barriers and provide guidance to resolve access challenges.
Cross Functional Collaboration
• Collaborate internally with Retail and Non-Retail Account Directors, Vaccine Sales teams and other partners within our client's Sales and Market Access teams.
• Coordinate with third party entities such as hubs, reimbursement services, and distribution partners.
Leadership & Business Ownership
• Manage daily activities that support appropriate access to our client's products.
• Operate independently and manage multiple projects simultaneously in a dynamic environment.
• Demonstrate leadership within the matrixed structure without direct reports.
Qualifications
• 4 year degree or 8+ years in related healthcare roles and/or pharmaceutical or medical industry.
• Ability to travel up to 60%, including overnight travel.
• Must live in reasonable proximity to the assigned territory.
• Valid driver's license.
• Strong customer focused mindset with demonstrated relationship building, problem solving, and project management skills.
• Ability to independently manage multiple initiatives with a high degree of ownership.
Preferred Qualifications
• Residence within 50 miles of a major metropolitan airport.
• 3+ years of experience in one or more of the following areas: Managed Care, Field Reimbursement, Patient Services and/or Sales (Specialty, Biologics, or Vaccines) or healthcare provider practice management.
• Reimbursement experience for vaccines or specialty infused/injected products in buy and bill settings across multiple sites of care.
• In depth knowledge of the vaccine payer environment, including commercial, state, federal, and private third-party coverage and reimbursement methodologies.
• Knowledge of provider office and hospital outpatient reimbursement environments, policies, and workflows.
• Comprehensive understanding of reimbursement dynamics for Medicare Parts A, B, C, D and state Medicaid.
• Knowledge of HCPCS, CPT, and ICD 10 coding regulations.
• Experience working with reimbursement hubs or support call centers to resolve patient access issues.