Field Reimbursement Manager, Oncology

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

📋 Description

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

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

• Share resources available to tackle access issues.

• Offer local expertise on national and regional payer policies, payer challenges, coding updates, and the correct claims submission processes.

• Work collaboratively with Oncology internal stakeholders for effective key account management.

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

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

• Stay informed about managed care, reimbursement, and policy developments.

• Travel is required approximately 50% of the time.

⛳️ Requirements

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

• Familiarity 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 policies, affordability support, and operations of patient support programs.

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

• In-depth knowledge 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 these credentials.

• Exceptional skills in territory and account management.

• A 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.

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

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

• Must reside within a reasonable distance from the primary city.

🏝️ Benefits

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

• Medical, dental, and vision insurance.

• 401(k) plan.

• Eligibility for participation in long-term incentive programs.