Field Reimbursement Manager, Oncology

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

📋 Description

• Provide education to healthcare professionals about patient support programs, including tools and services for access and reimbursement support.

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

• Share resources available to tackle access challenges.

• Offer local expertise on national and regional payer policies, address payer issues, explain coding changes, and guide appropriate claims submission processes.

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

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

• Develop and maintain relationships with relevant providers within the assigned territory.

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

• Work in a field-based territory, preferably with candidates residing within a reasonable distance from the primary city.

⛳️ Requirements

• Strongly preferred 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 operations of patient support programs.

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

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

• Must meet all relevant healthcare industry representative credentialing requirements and maintain good standing or be eligible to obtain them.

• Background checks, drug screenings, proof of immunization/vaccination, fingerprinting, and specific state or city licenses may be required.

• Excellent skills in territory and account management.

• A bachelor's degree is required.

• A valid driver's license is 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 track record of leadership in the current role is preferred.

• Willingness to travel 50% of the time is required.

🏝️ Benefits

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

• Medical, dental, and vision insurance.

• 401(k) plan.

• Eligibility to participate in long-term incentive programs.

• Potential for bonuses, commissions, incentives, and additional compensation, subject to the Company's discretion.

• Reasonable accommodations for applicants.

• Commitment to equal opportunity employment.