Strategic Access & Reimbursement Lead

The Lockwood Group®; Oakland (CA); On-site; USD 90,000 - 130,000; Full time

Job summary

Stratis Group is seeking an Access Reimbursement Manager (ARM) for a contracted role to support access for providers and patients. The ARM will educate healthcare offices on access processes, reimbursement solutions, and patient support programs across a defined territory.

The ARM will coordinate with HUB, call center, and market access teams, manage payer changes, and resolve patient-level reimbursement issues while maintaining PHI-compliant practices. Travel within the territory is required.

Qualifications

• 3+ years of experience in Managed Care, Field Reimbursement, Patient Services and/or Sales or healthcare provider practice management
• 4 year degree or 8+ years in related healthcare roles and/or pharmaceutical or medical industry
• Ability to travel 3-4 days a week, with overnights and flights, must reside within the territory
• 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
• Valid Driver's License

Responsibilities

• 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 provide in-person customer visits
• 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

Skills

Managed Care

Field Reimbursement

Patient Services

Sales (Specialty or Biologics)

Healthcare provider practice mgmt

Education

4 year degree or 8+ years in related healthcare roles and/or pharmaceutical or medical industry

Job description

Stratis Group is seeking an Access Reimbursement Manager (ARM) for a contracted role to support access for providers and patients. The ARM will educate healthcare offices on access processes, reimbursement solutions, and patient support programs across a defined territory.

The ARM will coordinate with HUB, call center, and market access teams, manage payer changes, and resolve patient-level reimbursement issues while maintaining PHI-compliant practices. Travel within the territory is required.