Field Reimbursement Manager, Oncology

Responsibilities

• Educate HCPs on patient support programs, including access and reimbursement support tools and services
• Educate on product-specific acquisition and access options such as specialty pharmacy networks, specialty distribution, and white-bagging support
• Educate on resources available to address access issues
• Provide local expertise in regards to national/regional payor policies in order to educate providers on payer issues, coding changes, and appropriate claims submission processes
• Collaborate with multiple Oncology internal stakeholders for key account management
• Report back payer trends related for approved products to Patient Services and MHC account management teams
• Establish and maintain relationships with appropriate providers within territory
• Remain current on key managed care, reimbursement, and policy activities

Qualifications

• Oncology and/or hematology-oncology experience strongly preferred, including experience with physician-administered therapies, buy-and-bill products, medical benefit reimbursement, specialty distribution/pharmacy, or complex access models
• Demonstrated understanding of coverage, coding, billing, reimbursement, benefit verification, prior authorization, appeals, claims submission, payer policy, affordability support, and patient support program operations
• Strong understanding and ability to communicate technical elements of coding and billing requirements at the National and Regional level across all settings of care
• Comprehensive understanding of Parts A, B, C and D or Medicare and associated reimbursement dynamics
• You must be in good standing and/or eligible to obtain the necessary HCIR credentialing requirements to gain and maintain entry into facilities and organizations that are in your assigned territory

Preferred Qualifications

• 5 or more years of industry experience in access and reimbursement or account management
• Extensive experience educating others on payer processes, requirement for coverage, and other access related situations for specialty medicines
• Strong track record of leadership within current role