Reimbursement ManagerAugust 30, 2021 2021-09-02 19:52
Website PEAR THERAPEUTICS
ABOUT PEAR THERAPEUTICS:
Pear Therapeutics is the leader in prescription digital therapeutics. We aim to redefine medicine by discovering, developing, and delivering clinically validated software-based therapeutics to provide better outcomes for patients, smarter engagement and tracking tools for clinicians, and cost-effective solutions for payers. Pear has a pipeline of products and product candidates across therapeutic areas, including severe psychiatric and neurological conditions. Our first product, reSET®, treats Substance Use Disorder and was the first prescription digital therapeutic to receive marketing authorization from the FDA to treat disease. Pear’s second product, reSET-O®, for the treatment of Opioid Use Disorder, received marketing clearance from the FDA in December 2018. Pear’s third PDT, Somryst®, is the first FDA-authorized prescription digital therapeutic (PDT) for patients with chronic insomnia and the first product submitted through FDA’s traditional 510(k) pathway while simultaneously reviewed through FDA’s Software Precertification Pilot Program.
The Patient Service Center (PSC) team is critical to Pear’s mission to create a better world by pioneering software as treatment for serious disease. The PSC team will be on the frontlines assisting patients and prescribers in enrolling, navigating and supporting patient access to Pear products. This team will contribute to the design and execution of the first ever, all digital Patient Services Center and enable Pear’s evolution into a ‘Virtual Care’ model.
As a Reimbursement Manager you will leverage your knowledge of the reimbursement landscape, partner with Market Access Key Stake Holders, and work with our sole pharmacy provider to identify and execute opportunities for Revenue Pull through of payer contracts. This role will help manage pull through of all future insurance plan agreements with PEAR including partnering with the PSC internal Operations team. You will also partner with internal data groups and Market Access for Rebate Agreement Data requirements. The Reimbursement manager will have opportunities to support finance in revenue reconciliation reporting and tracking. At times, this individual could be asked to participate in HCP, Site, or Payer calls to provide Payer/PSC perspective and help them align with PEAR.
- Manage Payer Agreement pull through in CRM, Data Reports, and Operational Teams (Including pivoting between DME, Medical, and Pharmacy Billing agreements)
- Understand & communicate potential future Payer Agreements within PSC to ensure readiness of change
- Provide input to Market Access team around management of rebate agreements as well as support data science with data provisions
- Manage certain PSC teams situationally to conduct investigational Benefit Verification research of key payer targets
- Manage Data teams to ensure proper reporting infrastructure in place to identify/track all patients with insurance plan agreements
- Operational oversight for all Grant/Bulk Programs including tracking of success and periodic meetings with Sales Teams
- Oversight of key Financial Assistance Programs including communications with our sole pharmacy provider ensuring patients receive proper support
- Partnership with Market Access Team to answer process related questions posed by insurance plans
- Management of Revenue reporting for PSC in partnership with the Finance Department
- Bachelor’s Degree
- 4-6 Years with reimbursement/billing experience
- Experience with Reimbursement/billing for DME Preferred
- Experience with Medical billing Preferred
- Healthcare/Manufacturer/Pharmacy experience Required
- Knowledge of claims and pharmacy operations Required
- Ability to use Microsoft Excel
- Experience with Sales Force Preferred
- Ability to partner cross-functionally with various departments
- Ability to thrive in dynamic environment
- Ability to manage multiple projects in a fast-paced, entrepreneurial environment
Equal Employment Opportunity:
Pear Therapeutics is committed to equal opportunity in the terms and conditions of employment for all employees and job applicants without regard to race, color, religion or religious creed, ancestry, age, sex (including pregnancy, childbirth, breastfeeding and related medical conditions), sexual orientation, gender identity or gender expression, national origin, genetic information, qualified physical or mental disability or handicap, medical condition, qualified military or veteran status, or any other basis protected by applicable law. Pear Therapeutics also follows all applicable national, state and local laws governing nondiscrimination in employment as well as employment eligibility verification requirements of the Immigration and Nationality Act. This policy applies to all terms and conditions of employment, including hiring, placement, promotion, termination, layoff, recall, transfers, leave of absences, compensation and training.
To apply for this job please visit peartherapeutics.com.