Virtual Access and Reimbursement Manager

The Virtual Access and Reimbursement Manager (vARM) will be responsible for educating healthcare providers (HCPs) and their staff on product-specific prior authorization and appeals processes, including how to access necessary forms and submission procedures. Field Force Collaboration will be critical for this role. The vARM is a remote employee who will virtually engage with accounts from an approved target list that will cover multiple states. This role supports a product within the men’s health space.

The Virtual Access and Reimbursement Manager will be a key member of both the client and Inizio Engage Patient Solutions teams. This role reports to the Director, Field Reimbursement.

What’s in it for you?

• Competitive compensation
• Excellent Benefits – accrued time off, medical, dental, vision, 401k, disability & life insurance, paid maternity and paternity leave benefits, employee discounts/promotions
• Employee discounts & exclusive promotions
• Recognition programs, contests, and company-wide awards
• Exceptional, collaborative culture
• Best Places to Work in BioPharma (2022, 2023, & 2024)
• Certified Great Place to Work (2022, 2023, 2025)

What will you be doing?

• Virtually engage with HCPs and appropriate office staff about product specific prior authorization & appeals process, how to access related forms, and high-level information about submission procedures and reauthorization requirements.
• Work with in-network Specialty Pharmacies on cases where the patient has provided consent.
• Educate HCPs and appropriate office staff on specific referral processes and patient assistance programs.
• Utilize approved resources and FAQs to provide education and answer questions as needed.
• Solid understanding of reimbursement issues that work within our core classes of trade:
  • Commercial Managed Care (Regional Plans)
  • Medicaid (Fee for Service, Managed Care Organizations)
  • Medicare (Part A, B, C, D; Carriers)
  • Veteran’s Administration (VISNs)
  • TRICARE Regional Offices
  • Specialty Pharmacy & Pharmacy Benefit Managers
  • ACOs and other Integrated Delivery Networks (IDNs)
  • Advocacy, consumer, provider and treatment systems groups
• Document call details within CRM with attention to data integrity to ensure compliance with program policies and business rules.
• Maintain confidentiality of Patient Health Information (PHI) and act in compliance with all laws, regulations, and company policies.
• Adhere to all Inizio and client policies, procedures, business rules, and call guides, as well as applicable laws.

Requirements for this position

• BS/BA Degree
• 3+ years of relevant experience in – reimbursement and patient access, market access, specialty pharmacy, or physician/system account management.
• Proven success operating in a virtual environment
• Experience in endocrine or men’s health disorders preferred.
• Strong knowledge and understanding of payer reimbursement models (medical and pharmacy), prior authorization and appeal requirements, coding changes, appropriate claim submission, integration of HUB and patient assistance programs
• Maintains compliance with program business rules, standard operating procedures and guidelines
• Highly organized with excellent attention to detail and the ability to multi-task in engaging both patients and providers.
• Passionate about learning and able to share/communicate that passion to others.
• Experience engaging HCP staff in a support role to educate on access pathways and product requirements.
• Experience navigating payer reimbursement process, preferably Medicare Part D (pharmacy benefit design and coverage policy).