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, access, and reimbursement support tools and services.

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

• Guide providers on the resources accessible to tackle access challenges.

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

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

• Report payer trends for approved products to the 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.

• Travel is expected to be around 50% of the time.

⛳️ Requirements

• Strong preference for candidates with 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.

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

• In-depth knowledge of coding and billing requirements at both the National and Regional levels across all care settings.

• Comprehensive understanding of Medicare Parts A, B, C, and D as well as their associated reimbursement dynamics.

• Must meet all relevant HCIR credentialing requirements and maintain good standing or be eligible to acquire these credentials.

• Exceptional territory and account management abilities.

• A bachelor's degree is required.

• A valid driver's license is necessary.

• Preference for candidates with 5 or more years of industry experience in access and reimbursement or account management.

• Extensive experience in educating others about payer processes, coverage requirements, and access-related situations related to specialty medicines is preferred.

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

• Ability to reside within a reasonable distance from the primary city or assigned territory.

🏝️ Benefits

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

• Medical, dental, and vision insurance.

• 401(k) retirement plan.

• Long-term incentive programs.

• Reasonable accommodations for applicants.

• Commitment to equal opportunity employment.