Field Reimbursement Manager, Oncology
About The Position
The Field Reimbursement Manager, Oncology is a field-based role. Candidates should live within a reasonable distance of the primary city; potential locations are Atlanta, Georgia; Columbia, South Carolina; Raleigh, North Carolina; or Richmond, Virginia. Hiring level will be commensurate with experience. The position involves educating healthcare providers on patient support programs, reimbursement and access resources, product acquisition options, payer policies, coding, and claims submission. The role also works with Oncology stakeholders, reports payer trends, manages territory relationships, and stays current on reimbursement and policy developments. Travel is 50% of the time. The position requires a bachelor’s degree, a valid driver’s license, strong territory and account management skills, and the ability to satisfy applicable healthcare industry representative credentialing requirements for facilities and organizations in the assigned territory. Oncology and/or hematology-oncology experience is strongly preferred. The role offers benefits including paid time off, medical, dental and vision insurance, and a 401(k), and is eligible to participate in long-term incentive programs.
Requirements
- Bachelor’s degree.
- Valid driver’s license.
- Demonstrated understanding of coverage, coding, billing, reimbursement, benefit verification, prior authorization, appeals, claims submission, payer policy, affordability support, and patient support program operations.
- Strong understanding of, and ability to communicate, technical coding and billing requirements at national and regional levels across all settings of care.
- Comprehensive understanding of Medicare Parts A, B, C, and D and associated reimbursement dynamics.
- Satisfy applicable healthcare industry representative credentialing requirements to gain and maintain facility and organization access within the assigned territory; be in good standing and/or eligible to obtain credentials.
- Excellent territory and account management skills.
Nice To Haves
- Oncology and/or hematology-oncology experience, including experience with physician-administered therapies, buy-and-bill products, medical benefit reimbursement, specialty distribution or pharmacy, or complex access models.
- Five or more years of industry experience in access and reimbursement or account management.
- Extensive experience educating others on payer processes, coverage requirements, and access-related situations for specialty medicines.
- Strong track record of leadership within the current role.
Responsibilities
- Educate healthcare providers on patient support programs, including access and reimbursement support tools and services.
- Educate providers on product-specific acquisition and access options, including specialty pharmacy networks, specialty distribution, and white-bagging support.
- Educate providers on resources available to address access issues.
- Provide local expertise on national and regional payer policies, including payer issues, coding changes, and appropriate claims submission processes.
- Collaborate with multiple Oncology internal stakeholders on key account management.
- Report payer trends related to approved products to Patient Services and MHC account management teams.
- Establish and maintain relationships with appropriate providers within the territory.
- Remain current on key managed care, reimbursement, and policy activities.
Benefits
- Paid time off, including vacation, holidays, and sick time.
- Medical insurance.
- Dental insurance.
- Vision insurance.
- 401(k).
- Eligibility to participate in long-term incentive programs.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
