Field Reimbursement Manager, Oncology

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

📋 Description

• Inform healthcare providers about patient support initiatives, access, and reimbursement assistance tools and services.

• Guide providers on product-specific acquisition and access alternatives, including specialty pharmacy networks, specialty distribution, and white-bagging assistance.

• Advise providers on resources available to resolve access challenges.

• Offer local expertise regarding national and regional payer policies, payer challenges, coding modifications, and correct claims submission procedures.

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

• Communicate payer trends for 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.

• Operate in a field-based position within a reasonable distance from the primary city.

⛳️ Requirements

• 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 intricate access models is strongly preferred.

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

• Strong knowledge and capability to articulate technical coding and billing guidelines at both national and regional levels across all care settings.

• In-depth understanding of Medicare Parts A, B, C, and D and related reimbursement dynamics.

• Must comply with all relevant healthcare industry representative (HCIR) credentialing prerequisites and be in good standing or eligible to acquire these credentials.

• Exceptional territory and account management skills.

• Bachelor's degree required.

• Valid driver's license is necessary.

• Preferably 5 or more years of industry experience in access and reimbursement or account management.

• Significant experience in educating others on payer processes, coverage criteria, and access-related scenarios for specialty medications is favored.

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

• Must be open to traveling 50% of the time.

🏝️ Benefits

• Paid time off (vacation, holidays, sick leave).

• Medical, dental, and vision insurance.

• 401(k) plan.

• Eligibility to engage in long-term incentive programs.