Field Reimbursement Manager, Oncology

AbbVie•Raleigh, NC

1d•$139,000 - $250,500

About The Position

The Field Reimbursement Manager, Oncology is a field-based role supporting providers with patient access and reimbursement for oncology products. Candidates should live within a reasonable distance of the primary city; eligible cities are Atlanta, GA; Columbia, SC; Raleigh, NC; and Richmond, VA. Hiring level will be commensurate with experience. The role requires travel 50% of the time. The manager educates healthcare professionals about patient support programs, access and reimbursement resources, product acquisition and access options, and available resources for resolving access issues. The position provides local expertise on national and regional payer policies, supports providers with payer issues, coding changes, and claims submission, and collaborates with Oncology stakeholders on key account management. The manager also shares payer trends for approved products with Patient Services and MHC account management teams and maintains provider relationships and knowledge of managed care, reimbursement, and policy developments.

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 the national and regional level across all settings of care.
Comprehensive understanding of Medicare Parts A, B, C, and D and associated reimbursement dynamics.
Must satisfy applicable healthcare industry representative (HCIR) credentialing requirements to gain and maintain entry into facilities and organizations in the assigned territory, and be in good standing or eligible to obtain credentials.
HCIR credentialing may include background checks, drug screens, proof of immunization or vaccination, fingerprinting, and specific state or city licenses; the employee is responsible for satisfying requirements and associated liability.
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.
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.

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 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.