Field Reimbursement Manager, Oncology

This is a fully remote position, open to applicants in Illinois, +1 more state.

📋 Description

• Provide education to healthcare providers regarding patient support programs, 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.

• Guide providers on resources available to tackle access issues.

• Offer local expertise on national and regional payer policies, payer challenges, coding modifications, and accurate claims submission processes.

• Collaborate with internal Oncology stakeholders on key account management strategies.

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

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

• Stay informed about managed care, reimbursement, and policy developments.

⛳️ Requirements

• Strong preference for experience in oncology and/or hematology-oncology.

• Preferred experience with physician-administered therapies, buy-and-bill products, medical benefit reimbursement, specialty distribution/pharmacy, or complex access models.

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

• Strong ability to communicate the technical aspects of coding and billing requirements at both national and regional levels across all care settings.

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

• Must meet all relevant healthcare industry representative (HCIR) credentialing standards.

• Must be in good standing and/or qualified to obtain necessary HCIR credentials.

• Excellent skills in territory and account management.

• Bachelor's degree required.

• Valid driver's license necessary.

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

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

• Strong record of leadership in the current role is preferred.

🏝️ Benefits

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

• Medical, dental, and vision insurance.

• 401(k) retirement plan.

• Long-term incentive programs.

• Travel opportunities (50% of the time).