Field Reimbursement Manager, Oncology

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

📋 Description

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

• Inform on product-specific acquisition and access options, covering specialty pharmacy networks, specialty distribution, and white-bagging assistance.

• Share resources available to help resolve access challenges.

• Offer local expertise on national and regional payer policies, payer issues, coding updates, and proper claims submission protocols.

• Collaborate with various internal oncology stakeholders for effective key account management.

• Report trends related to payers 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.

• Be prepared to travel 50% of the time.

⛳️ Requirements

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

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

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

• Capability 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 and their associated reimbursement dynamics.

• Must meet the required HCIR credentialing standards and be in good standing or eligible to obtain them.

• Exceptional skills in territory and account management.

• A Bachelor's degree is required.

• A valid driver's license is necessary.

• Preferably, 5 or more years of industry experience in access and reimbursement or account management.

• Significant experience in educating others about payer processes, coverage criteria, and access-related issues for specialty medications is preferred.

• A strong history 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 take part in long-term incentive programs.