Field Reimbursement Manager, Oncology

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

📋 Description

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

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

• Offer insights into available resources that tackle access issues.

• Deliver local expertise on national and regional payer policies, payer challenges, coding changes, and the appropriate processes for claims submission.

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

• Report on payer trends for approved products to Patient Services and the 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 will be required approximately 50% of the time.

⛳️ Requirements

• Strongly preferred experience in oncology and/or hematology-oncology.

• Preferred background in 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 policies, affordability support, and operations of patient support programs.

• Solid comprehension of coding and billing requirements at both national and regional levels across all healthcare 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 for these credentials.

• A bachelor's degree is required.

• A valid driver's license is necessary.

• It is preferred to have five or more years of industry experience in access and reimbursement or account management.

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

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

🏝️ Benefits

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

• Comprehensive medical, dental, and vision insurance.

• 401(k) plan.

• Eligibility to participate in long-term incentive programs.