Senior Field Reimbursement Manager

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

📋 Description

• Develop a solid understanding of clinical policies, coding guidelines, and prior authorization protocols necessary for prescribing and processing billing for FDA-approved products.

• Swiftly identify, communicate, and resolve outstanding billing reimbursement issues with the Director of National Accounts – Payers.

• Update the Field Sales Team about reimbursement obstacles specific to their territories, in accordance with Replimune Compliance guidelines.

• Utilize approved materials and recommend any necessary updates to the Market Access team marketer.

• Navigate reimbursement challenges through a clearly defined triage process.

• Collaborate regularly with the Director of National Accounts – Payer team to understand clinical policies related to Replimune FDA-approved products.

• Employ approved tools, such as dashboards and coding guides, to facilitate a smooth and efficient patient journey.

• Actively communicate with the Market Access account team to gain a comprehensive understanding of payer-based medical policies and clinical criteria for the use of FDA-approved Replimune products.

• Assist in the development, tracking, and reporting of key performance indicators to assess overall performance.

• Work alongside other field reimbursement managers to implement best practices.

• Provide guidance in creating tools to be used in the field to support product reimbursement efforts.

• Report updates to the Director of National Accounts – Payers regarding the status of approval and reimbursement for patients using FDA-approved products.

⛳️ Requirements

• A minimum of five (5) years of relevant reimbursement experience, ideally in oncology “Buy and Bill” settings within community and academic center environments.

• Extensive knowledge and understanding of the US healthcare payers, including Medicare, Commercial, Medicaid, and other payer types.

• Demonstrated success in product reimbursement and coding, preferably in oncology, with a focus on the melanoma therapeutic area being advantageous.

• In-depth knowledge of market access, patient access, and support services, particularly related to payer and provider reimbursement.

• Proven ability to foster working relationships with various teams to achieve shared objectives.

• Strong organizational skills with a focus on prioritization to meet established goals.

• Capable of communicating professionally with customers and stakeholders to build trust and credibility with healthcare providers.

• Willingness to travel as necessary to support the overall reimbursement process.

🏝️ Benefits

• Medical, dental, and vision insurance

• 401k match

• Flexible time off

• Paid holidays including year-end shutdown