Field Reimbursement Manager, Oncology

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

📋 Description

• Provide education to healthcare providers on patient support programs, encompassing access and reimbursement support tools and services.

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

• Educate providers regarding resources available to resolve access issues.

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

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

• Report payer trends associated with 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.

⛳️ 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 complex access models is preferred.

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

• Capability to convey technical coding and billing requirements at both National and Regional levels across various care settings.

• Understanding of Medicare Parts A, B, C, and D, along with associated reimbursement dynamics.

• Must fulfill applicable HCIR credentialing requirements and maintain good standing or be eligible to obtain necessary credentials.

• Strong skills in territory and account management.

• Bachelor's degree is required.

• A valid driver's license is necessary.

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

• Experience in educating others about payer processes, coverage requirements, and access-related matters for specialty medicines is preferred.

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

🏝️ Benefits

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

• Medical, dental, and vision insurance.

• 401(k) plan.

• Long-term incentive programs.

• Travel required (50% of the time).