Field Reimbursement Team Liaison I

Description

From intake to outcomes, CareMetx is dedicated to delivering industry-leading patient access solutions and support services that help patients quickly start and stay on specialty therapy treatments. We provide scalable, efficient digital hub services for pharmaceutical companies and healthcare providers, streamlining workflows with seamless integration for patient enrollment, consent, and prior authorization. Our best-in-class patient support services enhance every step of care, connecting patients, providers, and brands to drive better outcomes and accelerate time-to-therapy.

 

JOB TITLE: Field Reimbursement Team Liaison I

POSITION SUMMARY:

Under the general direction of the Operations Leadership, the Field Reimbursement Team Liaison will serve as the primary point of contact with the client’s field reimbursement team leaders to ensure open communication and resolution for problems in support of eliminating barriers for patients and providers to access therapy. The Field Reimbursement Team Liaison will be responsible for building a team environment with their applicable field counterparts, supporting open communication, performing root cause analysis of issues, tracking issues through to resolution, and ensuring program enhancements, process changes and program updates are shared back to the client’s field teams. They will serve as a patient advocate to the client and the providers to ensure all opportunities for improving patient access can be pursued.

PRIMARY DUTIES AND RESPONSIBILITIES:

• Partner with internal and external stakeholders to identify, anticipate and address patient and practice reimbursement issues.
• Be a subject matter expert on the payer landscape related to applicable disease state.
• Ensure processes are in place to drive clear communication with other field-facing teams to ensure clarity of reimbursement and access issues
• Provides exceptional customer service to internal and external customers; resolves any customer requests in a timely and accurate manner; escalates complaints accordingly.
• Coordinate closely with internal operational program staff and share customer feedback, as applicable.
• Provide coverage, coding, and reimbursement information to key staff members (i.e., practice administrators, reimbursement staff, and providers) to appropriately support patient access.
• Communicate with provider office staff on how to use patient access programs and services.
• Address questions associated with patient coverage, access, and reimbursement from accounts in collaboration and coordination with patient services as directed by policy and procedure.
• Keep abreast of customer and market access industry trends.
• Maintain thorough knowledge of Client’s Product(s)
• Participate as needed in client’s field team meetings to represent the operational program.
• Collaborate, communicate, and integrate closely with the assigned field reimbursement team leaders.
• Prepare reports for management as needed
• Manage ad hoc/urgent escalations as needed; recognize impact and report major escalations and issues to CareMetx Operational leadership and Executive Sponsor as needed.
• Partner with appropriate CareMetx cross functional teams (e.g. training, quality) to identify, develop and provide training for the operational team as needed.
• Maintain regular and reliable attendance, including being present, on time, and prepared for work as scheduled.
• Performs other related duties as assigned. 

EXPERIENCE AND EDUCATIONAL REQUIREMENTS:

• Bachelor’s degree or equivalent field experience required
• 3+ years of field reimbursement in the Pharmaceutical or Healthcare industries
• 1+ years of leadership experience, preferrable in the healthcare industry
• Proven track record of supporting HCPs and office staff in seeking access/reimbursement that required significant payer and reimbursement support
• Experience with both ‘buy and bill’ and Specialty Pharmacy distribution pathways for specialty oral and injectable medications
• Strong knowledge of the payer environment, including but not limited to: government and commercial payers, assignment of benefits, letter of agreements, accumulators, maximizers, manufacturer financial assistance
• Ability to professionally interact with customers – HCPs, office staff, clients
• Strong knowledge of patient support programs including HUB programs, co-pay assistance programs, and nurse educator support
• Strong planning and organization skills including OFFICE suite of productivity tools

MINIMUM SKILLS, KNOWLEDGE AND ABILITY REQUIREMENTS:

• Ability to communicate effectively both orally and in wr