Field Reimbursement Manager, Oncology

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

📋 Description

• Provide education to healthcare providers regarding patient support initiatives, access, and reimbursement assistance tools and services.

• Inform providers about product-specific acquisition and access methods, which include specialty pharmacy networks, specialty distribution, and white-bagging support.

• Offer insights into available resources to tackle access challenges.

• Share local expertise on national and regional payer policies, payer-related issues, coding modifications, and the proper processes for claims submission.

• Work collaboratively with internal Oncology stakeholders on managing key accounts.

• Report payer trends for approved products to the 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.

• Operate in a field-based capacity within a reasonable proximity to the primary city.

• Travel is required 50% of the time.

⛳️ Requirements

• Prior experience in oncology and/or hematology-oncology is highly preferred.

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

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

• Strong ability to communicate technical coding and billing requirements at both national and regional levels across various care settings.

• In-depth knowledge of Medicare Parts A, B, C, and D, along with their associated reimbursement dynamics.

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

• Excellent skills in territory and account management.

• Bachelor's degree is required.

• A valid driver's license is necessary.

• A minimum of 5 years of industry experience in access and reimbursement or account management is preferred.

• Extensive experience in educating others about payer processes, coverage requirements, and access-related scenarios for specialty medications is preferred.

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

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

🏝️ Benefits

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

• Comprehensive medical, dental, and vision insurance.

• 401(k) plan.

• Eligibility for long-term incentive programs.