Field Reimbursement Manager, Oncology

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

📋 Description

• Provide education to healthcare providers regarding patient support programs, as well as access and reimbursement assistance tools and services.

• Inform providers about specific product acquisition and access options, which encompass specialty pharmacy networks, specialty distribution, and white-bagging support.

• Educate providers on resources that can help resolve access challenges.

• Offer local expertise on national and regional payer policies, payer-related issues, coding modifications, and claims submission procedures.

• Collaborate with internal Oncology stakeholders for effective key account management.

• Report payer trends related to approved products to Patient Services and MHC account management teams.

• Build and sustain relationships with relevant providers within the designated territory.

• Stay updated on managed care, reimbursement, and policy developments.

• Function as a field-based representative within the assigned territory.

⛳️ Requirements

• Prior experience in oncology and/or hematology-oncology is highly preferred.

• Familiarity with physician-administered therapies, buy-and-bill products, medical benefit reimbursement, specialty distribution/pharmacy, or complex access models is strongly preferred.

• Proven understanding of coverage, coding, billing, reimbursement, benefit verification, prior authorization, appeals, claims submission, payer policy, affordability support, and operations of patient support programs.

• Capability to communicate technical coding and billing requirements at both national and regional levels across various care settings.

• In-depth knowledge of Medicare Parts A, B, C, and D, along with associated reimbursement dynamics.

• Must meet all relevant healthcare industry representative credentialing criteria.

• Should be in good standing and/or eligible to obtain the necessary credentials.

• Strong skills in territory and account management.

• Bachelor's degree is required.

• Valid driver's license is necessary.

• A minimum of 5 years of industry experience in access and reimbursement or account management is preferred.

• Extensive experience in educating others about payer processes, coverage requirements, and access challenges for specialty medicines is preferred.

• A strong record of leadership in the current role is preferred.

• Ability to reside within a reasonable distance from the primary city; candidates may live in Miami or Tampa, Florida.

• Willingness to travel 50% of the time.

🏝️ Benefits

• Paid time off, which includes vacation, holidays, and sick leave.

• Medical, dental, and vision insurance.

• 401(k) plan.

• Eligibility to participate in long-term incentive programs.

• Reasonable accommodations for applicants from the US and Puerto Rico.

• Commitment to equal opportunity employment.