Field Reimbursement Manager, Oncology

Job Description:

• Educate healthcare providers on patient support programs, access and reimbursement support tools, and services
• Educate providers on product-specific acquisition and access options, including specialty pharmacy networks, specialty distribution, and white-bagging support
• Educate on resources available to address access issues
• Provide local expertise on national and regional payer policies, payer issues, coding changes, and appropriate claims submission processes
• Collaborate with Oncology internal stakeholders on key account management
• Report payer trends for approved products to Patient Services and MHC account management teams
• Establish and maintain relationships with appropriate providers within the territory
• Remain current on managed care, reimbursement, and policy activities
• Work as a field-based representative within the assigned territory

Requirements:

• Oncology and/or hematology-oncology experience strongly preferred
• Experience with physician-administered therapies, buy-and-bill products, medical benefit reimbursement, specialty distribution/pharmacy, or complex access models preferred
• Understanding of coverage, coding, billing, reimbursement, benefit verification, prior authorization, appeals, claims submission, payer policy, affordability support, and patient support program operations
• Ability to communicate technical coding and billing requirements at national and regional levels across all settings of care
• Comprehensive understanding of Medicare Parts A, B, C, and D and associated reimbursement dynamics
• Must satisfy applicable HCIR credentialing requirements and be in good standing and/or eligible to obtain required credentials
• Excellent territory and account management skills
• Bachelor's degree
• Valid driver's license
• 5 or more years of industry experience in access and reimbursement or account management preferred
• Experience educating others on payer processes, coverage requirements, and access-related situations for specialty medicines preferred
• Strong track record of leadership within current role preferred
• Must live within a reasonable distance from the primary city
• Willingness to travel 75% of the time

Benefits:

• Paid time off, including vacation, holidays, and sick leave
• Medical, dental, and vision insurance
• 401(k)
• Participation in long-term incentive programs
• Resources to answer questions regarding HCIR credentialing responsibilities