The Field Reimbursement Manager (FRM) will provide field-based support and expertise to help resolve patient access issues, educate offices and hospitals on appropriate billing and coding for Valeant Pharmaceuticals, Inc. products, and provide educational services within relevant sites of care. The FRM will work directly with office support staff, hospital billing and coding staff, third party vendors (Helpline, Copay Card, Patient Assistance Program (PAP), and other important stakeholders involved with supporting patient access to Valeant Pharmaceuticals, Inc. therapies. FRMs will develop Key Opinion Leader (KOL) relationships, be involved in payer monitoring and support across Medicare Contractors, and lead the relationship with Medicare Contractor Medical Directors.
- The FRM will manage daily activities that support appropriate patient access to Valeant Pharmaceuticals, Inc. products across relevant sites of care to work as an extension of the patient assistance and 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 Valeant Pharmaceuticals, Inc. patient support services programs representatives on patient cases and claim issues.
- Educate office staff on the use of Valeant Pharmaceuticals, Inc. 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 Valeant Pharmaceuticals, Inc. products.
- Help develop KOL relationships in collaboration with Territory Managers (TMs) and Regional Account Managers (RAMs) related to payer initiatives.
- Monitor and attend Open Contractor Administrative Committee (CAC) Meetings for designated Medicare Administrative Contractors (MACs)
- Conduct policy surveillance across regional MACs to ensure appropriate coding, coverage, and payment of Valeant products.
- Attend and support relevant regional society meetings, coordinating support with TMs and Brand.
- 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.
- Coordinate travel schedules to attend important access meetings with Sales Force.
- Conduct pre-call planning meetings with TMs to ensure objectives and goals for each visit are established.
- Company-wide liaison with Third Party Hub Service Provider(s) and Valeant’s customers.
- Internal Contacts: Daily interaction with appropriate Sales Force and leadership, Key Account Managers (KAMs), Managed Markets Account Managers, and direct manager.
- This position requires the ability to act independently and to take initiative with minimal supervision from manager.
- Provide consultative reimbursement support to internal and external stakeholders.
- Able to troubleshoot reimbursement issues.
- Ability to diffuse situations within an office or hospital due to reimbursement concerns.
- Tailor approach and message to relevant stakeholders (i.e., nurse vs HCP vs biller)
- Advise manager of work schedule, priorities, problems, and of planned and unplanned absences.