Field Reimbursement Manager, Oncology

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

📋 Description

• Provide education to healthcare professionals regarding patient support programs, as well as access and reimbursement support tools and services.

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

• Deliver insights on resources that tackle access issues.

• Offer localized expertise on national and regional payer policies, issues, coding modifications, and claims submission procedures.

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

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

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

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

• Travel is required approximately 50% of the time.

⛳️ Requirements

• Experience in oncology and/or hematology-oncology is strongly preferred.

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

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

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

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

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

• Strong territory and account management skills are essential.

• A Bachelor’s degree is required.

• A valid driver's license is mandatory.

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

• Experience in educating others about payer processes, coverage requirements, and access situations for specialty medicines is preferred.

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

🏝️ Benefits

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

• Comprehensive medical, dental, and vision insurance.

• 401(k) retirement plan.

• Opportunity to participate in long-term incentive programs.