Field Reimbursement Manager, Oncology

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

📋 Description

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

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

• Offer insight on resources that can help address access challenges.

• Share local expertise concerning national and regional payer policies, related issues, coding modifications, and the proper processes for claims submission.

• Collaborate with internal Oncology stakeholders on key account management strategies.

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

• Build and sustain relationships with relevant providers in the designated territory.

• Stay updated on managed care, reimbursement, and policy activities.

• 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 advantageous.

• Knowledge of coverage, coding, billing, reimbursement, benefit verification, prior authorization, appeals, claims submission, payer policies, affordability support, and operations of patient support programs is essential.

• Ability to articulate technical coding and billing requirements at both national and regional levels across all care settings.

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

• Must meet applicable HCIR credentialing standards and be in good standing or eligible to acquire credentials.

• Background checks, drug screenings, proof of immunizations/vaccinations, fingerprinting, and specific state or city licenses may be necessary.

• Strong skills in territory and account management are required.

• A Bachelor's degree is mandatory.

• A valid driver's license is required.

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

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

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

🏝️ Benefits

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

• Medical, dental, and vision insurance coverage.

• 401(k) retirement plan.

• Eligibility for participation in long-term incentive programs.

• Option for remote work.

• Equal opportunity employer.