Clinical Nurse Specialist jobs in Irvine, CA

Description

You are an expert facilitator: you open doors, foster communication, and bridge the gap.

The Virtual Field Reimbursement Specialist (VFRS) will be responsible for the management of defined accounts in a specified geographic region across numerous therapeutic areas.

The VFRS will execute the collaborative territory strategic plan through partnership with internal and external stakeholders, which may include call center services (HUB), sales, market access, and other collaboration partners. Responsibilities include ensuring understanding of reimbursement process, field reimbursement services, and patient support programs. The Reimbursement Specialist will also work on patient-level reimbursement issue resolution.

In this role, the VFRS will demonstrate unwavering support and a consultative approach to help offices obtain insurance authorization and/or reimbursement of products for appropriate patients. The VFRS will have a direct impact on a patient’s ability to access the therapies they need. Additional responsibilities include:

• 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 the call center and/or HUB and provide live one-on-one coverage support
• Serve as payer expert for defined geography and able to communicate payer changes to key stakeholders in a timely manner
• Offer office education 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 materials provided by the client
• Review patient-specific information in reimbursement cases where the office has specifically requested assistance in resolving access issue or coverage challenge
• Educate physician office staff on the use of our client’s patient support services, including web based provider portals

Along with demonstrated initiative, resourcefulness and a results-oriented mindset, the ideal candidate has:

• Bachelor’s Degree
• Minimum two years of experience in public or private third party access arena or pharmaceutical industry in managed care, clinical support, and/or sales
• Experience with specialty/biologic or physician administered products
• Demonstrated ability to educate offices on access processes – including but not limited to:
  • Experience educating HCPs on client specific Patient Service programs (i.e. copay, nurse education, bridge, patient assistance, etc.)
  • Experience delivering educational presentations
  • Advanced knowledge of medical insurance terminology
• Knowledge of Centers of Medicare & Medicaid Services (CMS) policies and processes with expertise in Medicare Parts B & D
• Must live within territory or within territory boundaries.

The annual base salary for this position ranges from $112,000 to $118,000. The base salary range represents the anticipated low and high of the Syneos Health range for this position. Actual salary will vary based on various factors such as the candidate's qualifications, skills, competencies, and proficiency for the role. In addition, some positions may include eligibility to earn commissions/bonus based on company and / or individual performance.

At Syneos Health, we are dedicated to building a diverse, inclusive and authentic workplace. If your past experience doesn’t align perfectly, we encourage you to apply anyway. At times, we will consider transferable skills from previous roles. We also encourage you to join our Talent Network to stay connected to additional career opportunities.

Why Syneos Health? Our ability to collaborate and problem-solve makes a difference in patients’ lives daily. By joining one of our field access teams, you will partner with industry experts and be empowered to succeed with the support, resources, and autonomy needed to successfully navigate the complex reimbursement landscape. The diversification and breadth of our new and existing partnerships create a multitude of career paths and employment opportunities. Join our game-changing, global company dedicated to creating better, smarter, faster ways to get biopharmaceutical therapies to patients Experience the thrill of knowing that your everyday efforts are contributing to improving patients' lives around the world.

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Syneos Health companies are affirmative action/equal opportunity employers (Minorities/Females/Veterans/Disabled)

Syneos Health has a voluntary COVID-19 vaccination policy. We strongly encourage all employees to be fully vaccinated. Additionally, certain local governments or Syneos Health customers may have vaccine requirements that apply to some of our employees. These employees are required to submit proof of vaccination to Syneos Health and maintain compliance with these requirements.
At Syneos Health, we believe in providing an environment and culture in which Our People can thrive, develop and advance. We reward and recognize our people by providing valuable benefits and a quality-of-life balance. The benefits for this position will include a competitive compensation package, Health benefits to include Medical, Dental and Vision, Company match 401k, flexible paid time off (PTO) and sick time. Because certain states and municipalities have regulated paid sick time requirements, eligibility for paid sick time may vary depending on where you work. Syneos Health complies with all applicable federal, state, and municipal paid sick time requirements.

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