Field Reimbursement Manager

This is a fully remote position, open to applicants in United States.

📋 Description

• Ensure seamless patient access to PROVENGE within the designated geographical region.

• Create and execute strategies aimed at maximizing business growth opportunities.

• Analyze national, regional, federal, and state Medicaid payer policies to mitigate medical policy restrictions and reimbursement obstacles.

• Collaborate with decision-makers in medical practices, including CFOs, CEOs, pharmacy and medical directors, purchasing departments, and stakeholders in urology and oncology practices, hospitals, medical centers, and clinics.

• Eliminate practice reimbursement obstacles by supplying coverage and coding resources and facilitating access to PROVENGE.

• Provide timely market insights to corporate leadership regarding coverage and reimbursement trends, competitive updates, industry challenges, and opportunities.

• Inform providers about patient assistance programs and additional resources.

• Keep accounts updated on Commercial and Government payor policies that influence PROVENGE treatment access.

• Support the sales team with activities related to PROVENGE coverage, coding, reimbursement, access, pull-through, KOL, and champion development.

• Formulate strategies to overcome reimbursement barriers and educate customers to enhance their reimbursement confidence.

• Act as a resource on payer policies, reimbursement regulations and processes, practice management, Medicare and Medicaid guidelines, and HIPAA.

• Serve as a liaison between LASH and both internal and external customers regarding coverage, coding, and reimbursement.

• Document regional PROVENGE medical policies and contact information in SFDC.

• Adhere to OIG, FDA, and corporate policies and procedures.

⛳️ Requirements

• A BA or BS degree is required.

• An MBA or advanced degree is preferred.

• A minimum of 5 years of experience in the pharmaceutical/biotech/life-sciences industry, with 3–5 years specifically in healthcare coverage, coding, and/or reimbursement experience is required.

• Experience in the oncology/urology specialty is preferred.

• Experience in the buy and bill sector of reimbursement is required.

• Comprehensive understanding of coding, coverage, and reimbursement across community, academic, hospital, and IDN care settings.

• Extensive knowledge of Medicare, Medicaid, Managed Care, and Third Party payors is required.

• Advanced interpersonal skills for interaction with insurance company medical directors, practice administrators, CEOs, CFOs, pharmacy directors, and practice medical directors.

• Capacity to cover multiple regions with substantial overnight travel, estimated at 60%.

• Ability to sit or stand for prolonged periods.

• Intermittent walking to access work areas is necessary.

• Sufficient finger dexterity to operate a computer and complete paperwork.

• Adequate vision to use a computer and read written materials; sufficient hearing for telephone and in-person communications.

🏝️ Benefits

• Significant overnight travel estimated at 60%.

• Patient assistance programs and other resources are available to educate providers.

• Remote work location within the USA.