Virtual Access & Reimbursement Manager

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Virtual Access & Reimbursement Manager based in United States.

This contracted, field-based role provides dedicated virtual access and reimbursement support across evolving healthcare coverage landscapes. You will help healthcare provider offices navigate payer requirements, reimbursement processes, patient support services, and approved access resources. The position focuses on supporting appropriate patient access within the cardiovascular therapeutic area and may serve a range of provider specialties and account types. You will rapidly adapt to new territories, prioritize accounts, and maintain consistent customer support across changing geographic assignments. The role combines virtual provider education, payer and reimbursement expertise, issue resolution, and cross-functional collaboration. You will work closely with sales, market access, patient services, hub and specialty pharmacy partners, and other stakeholders within defined compliance requirements. Your work will directly contribute to a smoother access experience for healthcare providers and appropriate patients.

• Manage daily virtual activities through phone, Zoom, Webex, Teams, and other approved channels to support appropriate patient access to products and connect provider offices with relevant patient assistance and access services.
• Provide virtual coverage for field vacancies, underserved territories, white space, and overflow case management while maintaining consistent service levels.
• Rapidly assume responsibility for new territory assignments and adapt access strategies while maintaining continuity of program execution and customer support.
• Educate healthcare provider offices on Retail and Specialty Pharmacy prior authorizations, appeals, denials, reimbursement processes, payer requirements, and access pathways.
• Develop and execute territory access plans, prioritize accounts according to defined objectives, and coordinate activities with sales, market access, patient services, hub and specialty pharmacy partners, and other matrix stakeholders.
• Serve as an access and reimbursement resource for assigned geographies by monitoring payer policies, formulary coverage, utilization management requirements, pharmacy access pathways, prior authorization trends, denial patterns, and other access barriers.
• Educate healthcare providers and office staff throughout the access process, including formulary requirements, utilization management criteria, coding, insurance forms and procedures, benefits investigation, prior authorization, appeals, and claims resolution.
• Support patient-level access and reimbursement issue resolution when permitted by the approved program design and Rules of Engagement, accessing protected health information only when authorized and required.
• Use only approved materials, messaging, processes, and resources when communicating with healthcare providers, office staff, and field partners.
• Document appropriate activities and customer interactions in the approved CRM platform and participate in client, internal, and cross-functional meetings as required.
• Identify and communicate payer trends, field access insights, office workflow barriers, and reimbursement challenges to internal stakeholders to support continuous improvement.
• Recognize and report adverse events, product complaints, and other reportable information in accordance with applicable policies and requirements.
• Operate consistently within established compliance standards and Rules of Engagement while maintaining a consultative and customer-focused approach.

Requirements:

• You have 3+ years of experience in one or more relevant areas, such as managed care, field reimbursement, patient services, specialty or biologics sales, or healthcare provider office practice management.
• You have a four-year degree in a related field or equivalent professional experience.
• You can quickly integrate into new business environments, adapt to changing coverage needs and territory priorities, and maintain consistent execution in a dynamic setting.
• You have experience with Retail and Specialty Pharmacies and a strong understanding of reimbursement and access processes.
• Experience in cardiovascular or cardiology environments and hospital healthcare systems is highly desirable.
• You bring a solution-oriented mindset, strong business acumen, and analytical capabilities that support effective access and reimbursement problem solving.
• You have demonstrated experience educating healthcare provider offices and staff on access processes, issue resolution, and patient service programs such as copay support.
• You are comfortable delivering educational presentations both in person and through virtual platforms such as Zoom, Webex, or Teams.
• You possess advanced knowledge of medical insurance terminology and a strong understanding of CMS policies and processes, including Medicare Part D for pharmacy benefit products.
• You have proven relationship-building skills and can establish trusted partnerships with internal stakeholders while working effectively in collaborative teams.
• You are comfortable managing ambiguity, identifying solutions, and working independently with minimal supervision.
• You can prepare and submit required expense reports accurately and within established timelines.
• You hold a valid driver's license.

Benefits:

• The role offers a contracted, field-based work environment with virtual delivery capabilities and flexibility across changing territory assignments.
• You will gain extensive exposure to market access, reimbursement, payer landscapes, patient services, and pharmacy pathways within the cardiovascular therapeutic area.
• The position provides opportunities to work directly with healthcare providers and office staff while developing expertise in complex access and reimbursement processes.
• You will collaborate across sales, market access, patient services, pharmacy partners, and other cross-functional teams.
• The role offers opportunities to contribute field insights and process improvements that can strengthen patient and provider access experiences.
• You will work in a dynamic environment where adaptability, analytical thinking, and consultative problem solving are highly valued.
• The position provides opportunities to deepen expertise in healthcare reimbursement, Medicare processes, payer requirements, and patient access services.

We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team.

We appreciate your interest and wish you the best!

Why Apply Through Jobgether?

Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.

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