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ReplimunePosted 1 month ago

Sr Field Reimbursement Manager- West

$181,000–$234,500 year

On-siteWoburn, Massachusetts, United States or Woburn, Ontario, Canada

Full TimeSenior LevelMedium

Job Summary

Gain a firm understanding of clinical policies, coding guidelines, and prior authorization protocols required to prescribe and process billing for FDA-approved products. Quickly identify, communicate, and resolve outstanding billing reimbursement issues to the Director of National Accounts – Payers while informing the Field Sales Team of specific hurdles. Manage reimbursement challenges through a well-defined triage process, partner on routine basis to understand clinical policies, and use approved tools like dashboards to assist in making a smooth patient journey. Proactively communicate with the Market Access account team to gain a complete understanding of payer-based medical policies and clinical criteria. Assist in building, tracking, and reporting on key performance indicators, collaborate to implement best practices, and advise on developing tools for field product reimbursement. Conduct updates on the status of approval and reimbursement for patients. This field-based position resides within the Western US market area and requires travel as needed.

Required Qualifications

  • College Degree
  • Five (5) + years or relevant reimbursement experience preferably in oncology 'Buy and Bill' settings, including community and academic center environments
  • Comprehensive knowledge and understanding of the payers in the US health care system, including Medicare, Commercial, Medicaid and other payer archetypes
  • Strong knowledge of market access, patient access and support services, with an emphasis on payer and provider reimbursement
  • Ability to communicate with customers and stakeholders in a professional manner to build trust and credibility with health care providers
  • Travel as required to assist in the overall reimbursement process
  • Reside within the territory for which they are applying

Desired Qualifications

  • Proven track record in product reimbursement and coding, preferably in Oncology, with the melanoma therapeutic area a plus

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