West Virtual Access and Reimbursement Manager

Overview

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.

This position will support Pacific and Mountain Time zones within the US. Candidate must reside in either of those locations.

• 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 Bio Pharma (2022, 2023, & 2024)
• Certified Great Place to Work (2022, 2023, 2025)

• 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.

• 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).

Inizio Engage is a strategic, commercial, and creative engagement partner that specializes in healthcare. Our passionate, global workforce augments local expertise and diverse mix of skills with data, science, and technology to deliver bespoke engagement solutions that help clients reimagine how they engage with their patients, payers, people and providers to improve treatment outcomes. Our mission is to partner with our clients, improving lives by helping healthcare…