Field Reimbursement Manager, CAR-T

Educate the office staff around how to navigate the access and payer approval process, identifying access barriers that they’ll need to overcome, and highlighting actions that support access to therapy. Monitor, analyze, and triage situations which may adversely impact patient access to therapy. Liaise with entire Market Access department, other internal groups including sales, and medical groups to identify and resolve trending issues regarding patient access to therapies. Serve as subject matter expert for internal stakeholders and external office staff regarding the Medicare treatment guidelines, Medicaid Managed Care, commercial plans, policy changes, formulary status and the impact of healthcare reform on coverage. Maintain and share relevant information regarding account contacts, prior authorization requirements, trends, competitive intelligence, etc. with the Market Access Department. Educate peers in the Customer Care Area about various elements of Market Access, including reimbursement, medical coverage policies and medical benefit design. Execute business in accordance with the highest ethical, legal, and compliance standards, including timely and successful completion of all required training Requirements A minimum of a Bachelor’s degree is required Five years relevant experience of which three years are experience in specialty disease state(s) Must live within assigned geographic region Excellent technical knowledge and expertise in payer policy, including all elements of reimbursement (coding, coverage, and payment) Extensive experience in revenue cycle, buy-and-bill, formulary, prior authorization, coding, and appeals processes Candidates must live in close proximity to a major airport. A Valid Driver's License issued in the United States Advanced degree, or clinical license preferred Two years of reimbursement or relevant managed care experience Experience in multiple myeloma or related areas of oncology Proven ability to thrive in both an independent setting and in a cross functional / team environment. Strong knowledge as it relates to payer approval process, and solid business acumen. Strong organizational, problem solving and project management skills. Understanding of national and state legislative, Medicare, Medicaid, and private payer initiatives affecting reimbursement of pharmaceutical and biotechnology products. Success exhibiting peer leadership, mentorship and coaching to new hires as well as the rest of the team. Demonstrated competence with salesforce.com CRM use, native iOS app use, Microsoft Word, and Excel Superior communication skills (written and verbal) and excellent follow through Experience in the field, and especially in oncology Ability to develop and execute education plans Demonstrated ability to conduct field-based reimbursement and access support, education and consultation Demonstrated commitment to learning emerging technologies, such as AI, through exploration, iteration, and applying new tools over time. Resides in Virginia, West Virginia, Ohio, Michigan, Pennsylvania, Maryland, Washington DC, Delaware, Eastern TN, and Eastern KY. Candidates that live in other states may be considered. Core Competencies Demonstrates expertise in payer policy, reimbursement processes, and patient access strategies, with a strong focus on oncology and specialty disease states. Proven ability to educate and lead cross-functional teams while adhering to compliance and ethical standards. Highest-signal resume keywords Payer Policy Expertise Revenue Cycle Management Oncology Experience Project Management Skills Salesforce.com CRM Proficiency ATS Optimization Keywords Hard Skills Reimbursement Coding Prior Authorization Processes Formulary Management Appeals Processes Healthcare Reform Knowledge Patient Access Strategies Medical Coverage Policies Education Plan Development Data Analysis Competitive Intelligence Soft Skills Strong Communication Skills Organizational Skills Problem Solving Skills Mentorship and Coaching Team Collaboration Certifications & Qualifications Bachelor's Degree Advanced Degree or Clinical License Preferred Valid Driver's License Industry Keywords Market Access Medicare Guidelines Medicaid Managed Care Pharmaceutical Reimbursement Biotechnology Products Specialty Disease States Oncology Healthcare Compliance Legislative Initiatives Patient Access Barriers Tools & Technologies Salesforce.com Microsoft Word Microsoft Excel Native iOS Apps #J-18808-Ljbffr Jobtailor