Medical Information Replacement, Credit and Reimbursement Specialist

Job Title: Medical Information Replacement, Credit and Reimbursement Specialist

Position Summary:

The Medical Information Scientific Engagement team is seeking a highly skilled and motivated replacement, credit and reimbursement Specialist to join our team. The ideal candidate will possess extensive experience in developing innovative processes for replacements, credits and reimbursements that comply with regulatory requirements and align with government-funded programs. This role is critical for new product launches.

Essential Functions and Responsibilities:

· Develop and implement efficient processes for managing credits and reimbursements, ensuring alignment with applicable regulatory and government-funded program requirements.

· Collaborate with cross-functional teams to ensure that the credit and reimbursement strategies support our upcoming product launches.

· Analyze and understand wholesaler acquisition costs (WAC) to ensure our pricing strategies are competitive and compliant with government policies.

· Work closely with government agencies to facilitate the clearance of credits and reimbursement claims, maintaining effective communication and relationships.

· Stay updated on changes in regulations and government policies that impact reimbursement processes and communicate these to relevant stakeholders.

· Support the development of training materials and educate internal teams on best practices related to credits and reimbursements.

· Contribute to strategic planning for product launches with a focus on reimbursement and pricing strategies.

Preferred Skills:

· Experience in establishing new work instructions (WI) and/or standard operating procedures (SOP)

· Familiarity with government-funded programs and their reimbursement processes.

· Experience in developing and implementing innovative solutions to streamline reimbursement processes.

· Knowledge of pharmaceutical and healthcare industry trends and challenges.

Secondary Responsibilities

· Technology and Capabilities Support for GxP systems

o System Training Administrator

o UAT and Off-Script testing for GxP systems

o Project Coordination and Logistical Support

o Documentation Review (SOPs, Training, etc.)

· Training and Processes Support

o Support training and compliance programs and process meetings/updates.

o Perform training content reviews, training updates and suggest opportunities for training improvements/content.

o Sharing knowledge and guidance regarding training and compliance trends.

· Settlements

o Process customer requests for product replacements, credits and refunds, including contacting customers (HealthCare Professionals or Consumers) via multiple channels (Genesys).

o Documenting in CRM system (i.e. Salesforce.com).

· Administrative Support:

o Process hardcopy mail.

o Administrative duties as needed.

· Preferred Requirements:

o Knowledge and support of client IT tools including, but not limited to:

§ Salesforce.com/iConnect/Genesys Cloud

o Knowledge of Contact Center processes and policies

o Knowledge of Medical Information processes and policies

o Knowledge of Pharmaceutical Industry standards and compliance

Qualifications:

· Bachelor’s degree in healthcare, finance, business administration, or a related field.

· Proven experience working in credit and reimbursement roles, particularly with government agencies.

· Expertise in wholesaler acquisition costs (WAC) and its implications for product pricing and reimbursement strategies.

· Prior experience supporting a product launch, particularly in a regulated environment, is highly desirable.

· Ability to work independently, is detailed oriented, and must have excellent oral/written communication skills.

· Strong analytical skills with the ability to interpret complex regulations and policies.

· Excellent communication and interpersonal skills, with the ability to work effectively in a team environment

· Experience and demonstrate proven technical and computer skills, including standard MS Office Software.

· Project Management experience preferred.

· Highly skilled in customer service.

· Ability to understand root cause of issues and effectively resolve customer inquiries which may involve extensive analysis and research.

· Demonstrated analytical, problem-solver with solid organizational, and interpersonal skills.

· Excellent time management, planning and organizational skills.

· Meet challenging goals and timelines; quickly changes plans when data or actions require it.

· Able to work in a fast-paced structured environment with a team approach.

REQUIREMENTS