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.

• Educate stakeholders on available resources to tackle access-related challenges.

• Offer local expertise concerning national and regional payer policies, payer issues, coding changes, and the correct claims submission processes.

• Collaborate with internal stakeholders in Oncology on key account management initiatives.

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

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

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

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

⛳️ Requirements

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

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

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

• Solid grasp of technical coding and billing requirements, with the ability to communicate these at both national and regional levels across all care settings.

• Comprehensive knowledge of Medicare Parts A, B, C, and D and their associated reimbursement dynamics.

• Must meet all relevant HCIR credentialing requirements and be in good standing or eligible to obtain these credentials.

• Excellent skills in territory and account management.

• Bachelor's degree is required.

• A valid driver's license is necessary.

• Preferred candidates should have 5 or more years of industry experience in access and reimbursement or account management.

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

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

• Willingness to travel 75% of the time is required.

🏝️ Benefits

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

• Medical, dental, and vision insurance.

• 401(k) plan.

• Eligibility to participate in long-term incentive programs.