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, access, and reimbursement support tools and services.

• Inform on product-specific acquisition and access alternatives, which include specialty pharmacy networks, specialty distribution, and white-bagging support.

• Offer insights into resources available to resolve access challenges.

• Deliver local expertise concerning national and regional payer policies, payer issues, coding updates, and appropriate claims submission procedures.

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

• Report payer trends related to approved products to 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 territory with 50% travel required.

⛳️ 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.

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

• Ability to articulate technical coding and billing requirements at both national and regional levels across all care settings.

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

• Must meet all applicable HCIR credentialing requirements and maintain good standing or be eligible to obtain the necessary credentials.

• Exceptional territory and account management abilities.

• Bachelor's degree required.

• A valid driver's license is necessary.

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

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

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

• Willingness to travel 50% of the time.

🏝️ Benefits

• Paid time off, which includes vacation, holidays, and sick leave.

• Medical, dental, and vision insurance.

• 401(k) plan.

• Eligibility to participate in long-term incentive programs.