Raven Sumter

• Communicates complex reimbursement and access information clearly and effectively while building trust and influencing stakeholders at multiple levels.
• Navigates challenging reimbursement and access scenarios for Purified Cortrophin Gel (pharmacy benefit and 1 ML buy-and-bill) and ILUVIEN (buy-and-bill and pharmacy benefit), quickly identifying solutions and coordinating with internal and external cross-functional partners to drive resolution.
• Builds strong relationships with HCPs, HUB Partners, Specialty Pharmacies, Sales, Market Access, and others to achieve shared objectives.
• Provides player/coach leadership by mentoring colleagues; providing guidance on best practices, patient access strategies, compliance considerations, and patient centered approaches to resolving access barriers.
• Leads by example by consistently demonstrating professionalism, ethical conduct, and compliance on Sales, HCP, and cross functional interactions.
• Conducted training for the Ophthalmology Sales Team, delivering 13 sessions year to date, while supporting 13 sales reps across 11 states.

*Advanced from Field Reimbursement Manager (May 2019-May 2023)*

• Resolved 100% of claim issues, showcasing urgency and commitment to HCPs and their staff; earned 2023 High Impact Reward.
• Provided reimbursement and patient access expertise to 6 sales representatives and HCP offices across 5 states, proactively identifying and resolving access barriers.
• Cultivated relationships with HCP offices and internal stakeholders to educate on reimbursement requirements, payer policies, prior authorization, and claim resolution strategies.
• Served as a subject matter expert on reimbursement and access, providing guidance to Commercial Sales Team. HCPs, and cross functional partners.
• Designed and delivered reimbursement training aligned with Commercial Sales objectives, training over 50% of the sales force year-to-date through virtual learning platforms.
• Partnered closely with U.S. Learning and Development and Regional Sales Directors to identify training needs, develop educational strategies, and improve organizational reimbursement knowledge.
• Balanced field-facing responsibilities, reimbursement support, training initiatives, and competing business priorities while maintaining a high level of service and responsiveness.
• Chosen by Senior Leadership for 1:1 interview preparation and regional team discussions, showcasing trusted leadership, coaching, and communication skills.

*Advanced from Patient Case Coordinator (July 2014-August 2015)*

• Led training for 100+ Patient Access and Call Center employees during annual re-verification season, successfully managing competing priorities in a fast-paced results-driven environment.
• Led peer team initiatives in high-volume patient access environment, enhancing operational execution, employee development, and resolution of reimbursement related issues.
• Served as regional payer and reimbursement subject matter expert, collaborating with Regional Management to navigate complex HCP escalations and access-related challenges.
• Created and implemented step-by-step workflow job aids for new hires, improving process consistency and contributing to a 10% increase in customer satisfaction scores.
• Chosen for the Performance Accelerated Career Entry (P.A.C.E) Program, a leadership program designed to prepare high-potential employees for expanded organizational leadership responsibilities.

• Assisted members and clients with scheduling and reserving massage appointments while providing friendly, professional customer service.
• Led and supported the front desk team in completing daily clinic operations and responsibilities.
• Trained and mentored new employees on front desk procedures, customer service standards, and clinic operations.
• Performed daily opening and closing procedures to ensure the clinic was prepared for business and properly secured.
• Educated clients about clinic membership options and addressed questions and concerns while creating a welcoming and professional experience.