Mercalis · 9 hours ago
Field Reimbursement Manager (Oncology - South East Territory)
Valeris is a fully integrated life sciences commercialization partner focused on improving patient access to critical medications. As a Field Reimbursement Manager, you will resolve patient access issues and educate healthcare providers on billing and coding for client products, ensuring effective support for patient access to therapies.
Clinical TrialsHealth CareManufacturingMarketingPharmaceutical
Responsibilities
Solve complex patient access issues by working across the Hub, provider offices and communicating with client field team
Partner with Sales Team, Marketing, HCP, Specialty Pharmacies to create and drive strategic reimbursement support approaches, resulting in increased access to therapy for individual patients
Educate HCP and Office Staff on Patient Support Programs, per program specific operating policies and patient journey
On occasion, lead HCP offices in onsite education of program business rules, payer coverage, and other reimbursement related activities
The FRM will manage daily activities that support appropriate patient access to client’s products across relevant sites of care to work as an extension of the HUB reimbursement support services offered to providers
Review patient benefit options, prior authorization requirements, and alternate funding/financial assistance programs
Review appropriate billing and coding for products, assist with resolving reimbursement issues, and help ensure appropriate education to avoid future reimbursement hurdles
Coordinate with client’s patient support services programs representatives on patient cases and claim issues
Educate office staff on the use of client’s patient assistance and reimbursement support services, including but not limited to web-based provider programs and tools, and provide information on relevant reimbursement topics related to client’s products
Conduct policy surveillance across regional payers to ensure appropriate coding, coverage, and payment of client’s products
Assist providers with understanding local payer coverage and reimbursement trends through educational breakfast, lunch, and dinner programs
Lead sales training related to product reimbursement, as appropriate
Communicate reimbursement concerns and issues with appropriate internal stakeholders, including Sales and Managed Markets
Understand and monitor national and regional payer trends and changes
Work collaboratively with Managed Markets team to escalate potential payer issues
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
Ensure all SOPs are followed with consistency
Conducts miscellaneous tasks or projects as assigned
Qualification
Required
Associate's degree or higher in a related field or equivalent market experience
3+ years in Case Management Reimbursement Experience
3+ in the Pharma/Healthcare industry; working with Hubs, Payers, HCP or related area
Must have specific practice management, billing and/or coding experience for drugs, biologicals, or devices
Must have general payer policy knowledge including public and private payers, foundational knowledge of benefit verifications and prior authorization/pre-determination requirements and knowledge of reimbursement processes within various sites of care
Demonstrated ability to conduct field-based reimbursement support and education
Experience with new product launches, reimbursement billing, coding, and appeals process
Knowledge of private payer, Medicare and Medicaid structure, systems, and reimbursement process
Strong presentation skills
Job may require up to 30% travel on a weekly basis at some point
Valid Driver's License for those where travel required
Benefits
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&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
Company
Mercalis
Mercalis is an integrated life sciences commercialization that offers comprehensive solutions across the healthcare value chain.
Funding
Current Stage
Late StageTotal Funding
unknown2025-03-12Acquired
2011-05-18Series Unknown
Recent News
2026-01-20
2025-07-04
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