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 Virtual Access & Reimbursement Manager (ARM) is a client-facing and client-customer-facing role that will be responsible for managing multiple regions or territories (back-fill support), 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 Virtual ARM 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 ARM 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 ARM will abide in a compliant manner and will work closely within a defined set 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. The ARM will have a direct impact on providing a positive 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 the provider offices and work 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 client’s HUB, as appropriate and engage with customers virtually.
Participate in client meetings as appropriate. Participate in regularly scheduled team meetings and calls. Input call activity into customer CRM, as appropriate.
Serve as payer expert for defined geography and able to 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, defined by the client.
Educate physician office staff on the use of our client’s patient support services, including web-based provider portals.

Job Requirements:

Minimum three years of experience role in the pharmaceutical industry in managed care, patient services, and/or sales (specialty), or healthcare provider office practice management
Solution oriented mindset, strong business acumen, & strong analytic capabilities
Experience with specialty/biologic products and/or complex reimbursement process
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 of 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