Kimberly Ridley Email & Phone Number

Raleigh, North Carolina, United States

• Oversees the day-to-day operations of a market access and reimbursement team that includes Nurse Educators, Field Reimbursement Managers, Specialty Pharmacy Liaisons, and Care Coordinators.• Partner with client field sales team, HCP, Specialty Pharmacies to create and drive strategic reimbursement support approaches, resulting in increased access to therapy for individual patients.• Educate on and represent patient support programs to internal and external stakeholders including sites of care and client sales and field support teams. • Work cross functionally with all market access areas internally and externally to meet deadlines and deliverables. • Serve as a field liaison to the sales team and healthcare providers regarding insurance coverage, medical billing, reimbursement process, and general access for complex pharmaceuticals.• Lead and facilitate conference calls with specialty pharmacy contacts to monitor patient progress, reconcile data discrepancies, research missing data, and provide updates as requested on patient journey. • Contribute to the analysis and writing client reports and other deliverables, such as Business Rules, SOPs, Change Orders, SOWs and Contracts• Create project plans, establish/lead team meetings. Develop, communicate project scope, objectives, and deliverables for the team. Closely monitoring projects according to deadlines.• Participate in interviewing prospective employees, evaluating current employees, and training employees.• New Program Launch experience• Orphan drug experience• Rare disease experience • REMS experience

Fort Mill, South Carolina, United States

Currently managing 15 direct reports for a Pfizer Oncology Patient Assistance Program. • Ensure program is operating according to contractual obligation, SOPs and within SLAs• Support the Director and Senior Manager on initiatives, analytics, and reporting for internal and external meetings• Providing day to day guidance to 15 direct reports, monitoring compliance to program policies, monitoring productivity, and ensuring adherence to quality expectations• Facilitate internal meetings communicating the client's goals and interests to the team to build and maintain a cohesive relationship between the client expectations and program• Conduct formal and informal discussions with direct reports to include yearly performance reviews and hold regular one on one discussions to review productivity and future career goals• Drive program performance by establishing metrics and goals• Manage client expectations and making recommendations on potential solutions by identifying program issues • Deliver routine client reports• Analyze quality and performance reports for trends, make process improvements, and provide coaching and feedback when needed• Collaborate across various groups on program projects, database updates and UAT• Resolve client and patient escalations• Partners with talent acquisition and hiring managers in recruiting, interviewing, hiring, and onboarding employees• Highly experienced with reimbursement support program processes, patient assistance programs for the uninsured and underinsured, and copayment assistance• Provide one-on-one training and mentoring for new associates

Fort Mill, South Carolina, United States

• Perform Quality Audits on all program associates• Monitor and evaluate randomly selected calls to uphold customer service and program expectations • Ensuring adherence to company, program and client expectations and policies• Understands and complies with core standard operating procedures• Identifying and ensuring all Adverse Events are being properly identified, documented, and reported • Monitor and track associate performance metrics • Identified areas of quality improvement• Provide feedback and coaching to associates to improve performance, program knowledge and overall customer service• Identify trends across the program and sending out program reminders to help improve quality metrics• Sending the Quality reports to all managers to show scoring consistency and identify areas of improvement• Scrubbing calls for the client• Completing the monthly Pfizer Adverse Event Call Audit • Pulling call reports and metrics as needed, per client or management request• Making sure all required associate audits are completed on time each month

Fort Mill, South Carolina

• Served as an advocate to patients regarding eligibility requirements, program enrollment, reimbursement process, affordability support, and general access for prescribed therapy.• Responsible for insurance benefit investigations, assisting in the PA/Appeals process and triage cases according to program standard operating procedures.• Served as direct point of contact to health care providers for ongoing support and relationship development by acquiring and delivering detailed information regarding a program and/or a patient.• Provided information on relevant reimbursement topics related to the clients product.• Completed site visits with the offices to discuss patients on the free-drug program and assist with reimbursement issues.• Ability to understand and explain benefits offered by all payer types including private/commercial and government (i.e., Medicare, Medicaid, VA and DOD).• Acted as an assigned liaison to client contacts (e.g., regional contact for sales representatives), Program Management, other internal stakeholders and Healthcare Providers.