Field Reimbursement Manager, Oncology

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

📋 Description

• Provide education to healthcare providers regarding patient support programs, as well as 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 the resources available to tackle access challenges.

• Offer local expertise on national and regional payer policies, payer issues, coding updates, and the proper processes for claims submission.

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

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

• Build and maintain 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

• Preferred experience in oncology and/or hematology-oncology.

• Background in physician-administered therapies, buy-and-bill products, medical benefit reimbursement, specialty distribution/pharmacy, or complex access models is 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.

• Strong grasp of coding and billing requirements at both national and regional levels across all care settings.

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

• Must meet applicable healthcare industry representative (HCIR) credentialing requirements and be in good standing or eligible to obtain these credentials.

• Excellent skills in territory and account management.

• Bachelor's degree required.

• Valid driver's license necessary.

• Preferred 5 or more years of industry experience 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.

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

• Willingness to travel 50% of the time.

🏝️ Benefits

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

• Medical, dental, and vision insurance.

• 401(k).

• Eligibility to participate in long-term incentive programs.