Job Title: Associate Director - Field Reimbursement -Oncology
Salary: Minimum: $144,000.00 | Maximum: $216,840.00 | Target: $200,000.00
Bonus: Available
JOB DESCRIPTION
Associate Director - Field Reimbursement - Oncology
PURPOSE
This role is responsible for ensuring patient access to oncology products within a designated geographical region by assisting healthcare providers (HCPs) and office staff with navigating therapy prior authorizations (PAs), medical necessity documentation, and handling appeals for therapy PA denials. The individual will establish collaborative partnerships with HCPs and office personnel to facilitate patient access to treatments. This position involves working closely with decision-makers in medical practices, clinical administrators, key office support staff, and clinical pharmacists to assist with health plan or pharmacy benefit manager (PBM) therapy approval requests. Additionally, the role requires coordination with the Patient Support Services Team, Market Access Field Teams, Area General Managers (AGMs), Sales Consultants (SCs), and Medical Science Liaisons (MSLs) to implement reimbursement and access programs that minimize access and affordability barriers for patients using Bayer oncology products. The coverage area includes Georgia, Alabama, Florida, and part of South Carolina, with up to 50% travel required within the territory. Candidates must reside within the assigned territory.
KEY TASKS AND RESPONSIBILITIES
Extensive disease state/therapy space experience
Govt, National and local Commercial Payer experience, State Medicaid, and Managed Plans
Experience in educating and supporting Prior Authorization process, appeals, and denials
Cover my meds – portal access experience a plus
Proactive education
Stay current with local MAC policies and procedures
Excellent verbal and written communication skills as well as prior experience educating providers
Collaborating across multiple stakeholders
Proactive Problem solving, defusing, and resolving escalations, consistent and timely follow up
Proven experience in flexibility and adaptability Territory Management
Ability to engage and navigate HCPs in various settings including hospitals, private practice, large multi-specialty practices, IDNs, IDN out-patient clinics and other facilities
Initiative-taking business acumen to identify and resolve HCP/Office Staff issues/challenges with Payer/PBM therapy approvals
New Product / Indications launch experience
Must have a valid driver's license with a safe driving record/ MVR
Specialty Pharmacy Experience
Experience educating and/or supporting pharmacies.
We are seeking an incumbent who processes the following:
REQUIRED QUALIFICATIONS
Bachelor’s Degree or minimum of 5 years healthcare related reimbursement experience
2 + years Field Reimbursement experience
In depth understanding of Payer/PBM therapy approval requirements (Prior Authorization, Medical Necessity, Denial Appeals, Formulary coverage and payment for oncology therapies across all sites of care (hospital, clinic, integrated delivery network) and ability to apply this knowledge to address individual customer concerns
Broad knowledge of Medicare, managed care, third party payers and Medicaid
Demonstrated excellence in meeting and exceeding customer expectations especially in demanding situations
Ability to effectively address customer concerns in a timely fashion and by working collaboratively with external and internal stakeholders
An elevated level of sophistication/people skills needed to interact with practice clinical decision makers, office support staff, clinical pharmacists, and office managers
Must demonstrate a comprehensive knowledge of customer relations, therapy formulary coverage, utilization management, and able to interpret complex information
Must possess the leadership ability to effectively organize, communicate and collaborate with HCPs, Key Practice Staff and Bayer external and internal team members
Exceptional knowledge of Healthcare Management
Pharmaceutical Manufacturer federal, state, and local compliance requirements
Area Reimbursement Managers will cover multiple regions, thus significant overnight travel, up to 50%
Must have a valid driver's license with a safe driving record/ MVR.
PREFERRED QUALIFICATIONS
2 + years Oncology Field Reimbursement Experience
Experience in oncology and working with key oncology stakeholders.
Additional compensation may include a bonus or commission (if relevant). Additional benefits include health care, vision, dental, retirement, PTO, sick leave, etc..
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