Field Reimbursement Manager, Oncology

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

📋 Description

• Provide education to healthcare professionals regarding patient support programs, which include tools and services for access and reimbursement support.

• Inform about product-specific acquisition and access alternatives, such as specialty pharmacy networks, specialty distribution, and white-bagging assistance.

• Guide providers on the resources available to tackle access challenges.

• Offer local insights on national and regional payer policies, related issues, coding updates, and the correct processes for claims submission.

• Work collaboratively with internal Oncology stakeholders on key account management initiatives.

• Track and report payer trends associated with approved products to the Patient Services and MHC account management teams.

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

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

• Travel is required approximately 75% of the time.

⛳️ Requirements

• Preferably have experience in oncology and/or hematology-oncology.

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

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

• Solid grasp and ability to articulate the technical aspects of coding and billing requirements at both the National and Regional levels across all care settings.

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

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

• Must be in good standing and/or eligible for obtaining necessary HCIR credentials.

• Excellent skills in territory and account management.

• Bachelor’s degree is required.

• A valid driver's license is required.

• Preferably have 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 scenarios for specialty medicines is preferred.

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

🏝️ Benefits

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

• Medical, dental, and vision insurance coverage.

• 401(k) plan.

• Eligibility to engage in long-term incentive programs.