Access & Reimbursement Manager (Cleveland, OH)

Job Description

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 Access & Reimbursement Manager (ARM) is a client-facing role responsible for managing a dedicated territory to support access for providers 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 ARM will execute a region or territory strategic plan through partnerships 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 the client’s patient support program. The ARM will also work on patient-level reimbursement issue resolution, requiring access to and experience with patient health information (PHI). The ARM will abide by compliance regulations and will work closely within a defined set of Rules of Engagement.In this role, the ARM will demonstrate a compliant and consultative approach to help offices obtain insurance authorization and/or reimbursement of products for appropriate patients, directly impacting the experience for both the HCP Customer and Patient. Additional Responsibilities Include: Manage daily activities that support appropriate patient access to our client’s products in provider offices and act as a liaison to other patient assistance and access support services offered by our clients (i.e. HUB, Call Center, Specialty Pharmacy Services). Act as an extension of the client’s HUB, as appropriate, and provide in-person customer visits. Participate in client meetings as appropriate and regularly scheduled team meetings and calls. Input call activity into customer CRM, as appropriate. Serve as payer expert for defined geography and communicate payer changes to key stakeholders in a timely manner. Provide office education and awareness during the entire access process, which may include formulary coverage/utilization management criteria, insurance forms & procedures, benefits investigation, prior authorization, appeal, and/or claims resolution. Educate offices using approved educational materials provided by the client. Review specific patient case information in a compliant manner, as defined by the client. Educate physician office staff on the use of our client’s patient support services, including web-based provider portals. Desired Job Requirements: 3+ years of experience in one or more of the following areas: Managed Care, Field Reimbursement, Patient Services, and/or Sales (Specialty or Biologics), or healthcare provider office practice management. 4-year degree in related field or equivalent experience. Ability to travel 3-4 days a week, with overnights (as needed), must reside within the Territory. Solution-oriented mindset, strong business acumen, & strong analytic capabilities. Experience with specialty/biologic products and/or complex reimbursement processes. Demonstrated ability to educate offices on access processes and issue resolution. Experience educating HCPs on client-specific Patient Service programs (i.e. copay, nurse education, bridge, patient assistance, etc.). Experience delivering educational presentations in person and/or via technology platforms such as Zoom, Webex, and/or Teams. Advanced knowledge of medical insurance terminology. Knowledge of Centers for Medicare & Medicaid Services (CMS) policies and processes with expertise in Medicare (Part B – for buy & bill products and Part D for Pharmacy products). Ability to manage ambiguity & problem-solve. Prepare and submit appropriate expense reports in a timely fashion. Valid Driver’s License. #J-18808-Ljbffr