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Access & Reimbursement Manager

2 hours, 48 minutes ago
United States
Contract
Mid Level
Sales Representative
Sales and Business Development
CRM
Apply Now
The Lockwood Group

The Lockwood Group

The Lockwood Group provides specialized medical and market access communications services tailored for the pharmaceutical, biotech, and medical device industries, collaborating closely with clients to develop and implement effective strategies that sup...

Professional Services
251-1K
Founded 2007
View All Jobs 5

Description

  • Develop and execute a territory access plan and prioritize provider accounts according to client objectives.
  • Educate healthcare providers and office staff on payer requirements, reimbursement processes, coding, benefits investigation, prior authorizations, appeals, denials, and claims resolution.
  • Manage daily activities supporting appropriate patient access and liaise with patient assistance, hub, specialty pharmacy, and other access services.
  • Conduct in-person customer visits and deliver educational presentations through approved in-person or virtual channels.
  • Monitor payer policies, formulary coverage, utilization management requirements, pharmacy access pathways, authorization trends, denial patterns, and other access barriers.
  • Coordinate compliantly with sales, market access, patient services, pharmacy partners, and other matrix stakeholders within established Rules of Engagement.
  • Document customer interactions and activities in the approved CRM platform and participate in internal and client meetings.
  • Provide compliant support for patient-level access and reimbursement issue resolution when authorized, including appropriate handling of PHI.
  • Communicate field insights, payer trends, workflow barriers, and reimbursement challenges to internal stakeholders.
  • Recognize and report adverse events, product complaints, and other reportable information according to client policy and applicable requirements.

Requirements

  • 3+ years of experience in managed care, field reimbursement, patient services, specialty or biologics sales, or healthcare provider office practice management.
  • Four-year degree in a related field or equivalent experience.
  • Experience with retail and specialty pharmacies and pharmacy benefit products.
  • Advanced knowledge of medical insurance terminology, reimbursement processes, prior authorizations, appeals, denials, and claims resolution.
  • Knowledge of CMS policies and processes, including Medicare Part D.
  • Demonstrated ability to educate healthcare providers and office staff on access processes and client-specific patient service programs, such as copay support.
  • Cardiovascular or cardiology and hospital healthcare systems experience preferred.
  • Experience delivering educational presentations in person or through Zoom, Webex, Teams, or similar platforms.
  • Strong analytical, business, problem-solving, relationship-building, and teamwork skills, with the ability to manage ambiguity.
  • Ability to travel 3–4 days per week, including overnight travel as needed, and reside within the assigned territory.
  • Valid driver’s license and ability to submit timely expense reports.

Interested in this position?

Apply directly on the company website

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