Field Reimbursement Manager, Oncology

AbbVie•Atlanta, GA

18h•Onsite

About The Position

The Field Reimbursement Manager is a field-based role supporting oncology providers in the assigned territory. Candidates should live within a reasonable distance of the primary city; eligible locations are Atlanta, Georgia; Columbia, South Carolina; Raleigh, North Carolina; or Richmond, Virginia. The hire will be made at a level commensurate with experience. The role educates healthcare professionals on patient support programs, access and reimbursement tools, product-specific acquisition and access options, and resources for resolving access issues. It provides local expertise on national and regional payer policies, helps providers understand payer issues, coding changes, and claims submission processes, and collaborates with internal oncology stakeholders on key account management. The manager also reports payer trends for approved products to Patient Services and MHC account management teams, builds provider relationships, and stays current on managed care, reimbursement, and policy activities. The position requires meeting applicable health care industry representative (HCIR) credentialing requirements for access to facilities and organizations in the territory, and remaining in good standing or eligible to obtain credentials. Requirements may include background checks, drug screens, proof of immunization or vaccination, fingerprinting, and licenses required by specific states or cities. Candidates are responsible for satisfying these requirements and associated liabilities.

Requirements

Oncology and/or hematology-oncology experience is strongly preferred, including experience with physician-administered therapies, buy-and-bill products, medical benefit reimbursement, specialty distribution or pharmacy, or complex access models.
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.
Meet applicable HCIR credentialing requirements and be in good standing or eligible to obtain required credentials.
Excellent territory and account management skills.
Bachelor’s degree.
Valid driver’s license.

Nice To Haves

Five or more years of industry experience in access and reimbursement or account management.
Extensive experience educating others on payer processes, coverage requirements, and other access-related situations for specialty medicines.
Strong track record of leadership within the current role.

Responsibilities

Educate healthcare professionals 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 internal oncology 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.
Satisfy applicable HCIR credentialing requirements to gain and maintain entry into facilities and organizations in the assigned territory.