Field Reimbursement Manager, Oncology

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

📋 Description

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

• Inform about product-specific acquisition and access pathways, which include specialty pharmacy networks, specialty distribution, and white-bagging assistance.

• Offer insight into resources designed to resolve access challenges.

• Supply local expertise concerning national and regional payer policies, payer-related issues, coding updates, and claim submission procedures.

• Work in collaboration with internal Oncology stakeholders on key account management initiatives.

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

• Travel within the assigned territory approximately 50% of the time.

⛳️ Requirements

• Previous 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.

• Solid comprehension of coding and billing requirements at both national and regional levels across various care settings.

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

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

• Exceptional territory and account management skills are essential.

• A Bachelor’s degree is required.

• A valid driver's license is necessary.

• 5 or more 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 issues for specialty medicines is preferred.

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

• Ability to travel 50% of the time is required.

• Candidates should reside within a reasonable distance from the primary city; living in Lexington, Kentucky, or Cleveland, Ohio, is acceptable.

🏝️ Benefits

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

• Medical, dental, and vision insurance.

• 401(k) plan.

• Eligibility to participate in long-term incentive programs.

• Support for reasonable accommodations.

• Commitment to equal opportunity employment.