Field Reimbursement Manager, Oncology

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

📋 Description

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

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

• Offer guidance to providers on the resources available to resolve access challenges.

• Share local expertise concerning national and regional payer policies, payer challenges, coding updates, and suitable claims submission procedures.

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

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

• Build and maintain relationships with relevant providers within the designated territory.

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

• Operate in a field-based role located within a reasonable distance from the primary city.

• Travel is required 50% of the time.

⛳️ Requirements

• Prior 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 patient support program operations.

• Strong 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 along with related reimbursement dynamics.

• Must meet all relevant healthcare industry representative credentialing requirements and maintain good standing or be eligible to obtain these credentials.

• Exceptional territory and account management skills.

• 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 issues concerning specialty medicines is preferred.

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

🏝️ Benefits

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

• Medical, dental, and vision insurance coverage.

• Participation in a 401(k) plan.

• Eligibility for long-term incentive programs.

• Required travel is 50% of the time.