About the RoleThis role is responsible for overseeing and managing the verification of benefits process ensuring efficient, accurate policy reviews and effectively handling referral complexities. Obtaining accurate benefits is the first step in the financial process meaning accuracy is key as it determines patient responsibility and our ability to get reimbursed for services.
Our team is composed of passionate, forward-thinking professionals eager to take on the challenge of the mental health crisis and play a formative role in providing life-saving solutions. We are looking for a candidate who is inspired by our mission and excited by the opportunity to build a business that will impact millions of lives in a profound way.
Responsibilities- Collect and analyze data from various sources, including payer policies, reimbursement trends, market access, and formulary status, to inform payer strategies.
- Monitor and assess payer trends, including reimbursement levels, formulary placement, and health policy changes to help predict and address potential impacts on product access.
- Support the development of market access strategies, working cross-functionally with Commercial Strategy, RCM, and other teams.
- Prepare reports and presentations summarizing key insights, payer feedback, and market dynamics for senior leadership.
- Support the tracking and analysis of payer performance metrics to measure the effectiveness of access and reimbursement strategies.
- Help maintain and update databases and tools used to track payer access and reimbursement status.
- Provide recommendations on payer strategy adjustments based on evolving market conditions or payer behavior.
Requirements- 1-3 years of experience in the healthcare industry (patient account representative, insurance collections, payer strategy, market access, healthcare consulting, or a similar field.
- Strong understanding of payer dynamics, including reimbursement, formulary management, and market access strategies.
- Proficient in data analysis and reporting, with the ability to synthesize complex information into clear, actionable insights and trending patterns.
- Knowledge of government programs such as Medicaid and commercial payer structures.
- Proficiency in Microsoft Office Suite (Excel, PowerPoint, Word); experience with data analysis tools or CRM software is a plus.
- Excellent written and verbal communication skills, with the ability to communicate complex ideas to both technical and non-technical audiences.
- Strong organizational skills and ability to manage multiple projects and priorities simultaneously.
BenefitsCharlie Health is pleased to offer comprehensive benefits to all full-time, exempt employees. Read more about our benefits here.#LI-HYBRID