Associate Director- Field Reimbursement- Oncology

Tampa, FL US

Posted: 09/03/2024

Job Category: Medical

Job Number: HA4185893

Job Title: Associate Director - Field Reimbursement – Oncology

Job Location: GA, AL, FL, and SC

Job Type: Full-time, Direct Hire

Salary Range: $144,000- $216,000

Travel: Yes, 50%

PURPOSE

Responsible for ensuring patient access to oncology products within assigned geographical area via supporting HCPs and Office staff in navigating therapy Prior Authorizations (PAs), Medical Necessity documentation and therapy PA denial appeals. Develop collaborative working partnerships with HCPs and Office Staff, to support Patient access to therapies. This position works with medical practice therapy decision makers, practice clinical administrators, key office support staff and clinical pharmacists to assist with Health Plan/PBM therapy approval requests. This position is also responsible for collaboration with the Company Patient Support Services Team, Market Access Field Teams, Company AGMs, SCs and MSLs to execute reimbursement and access programs to reduce access and affordability hurdles for patients on oncology products. The span of coverage will be GA, AL, FL, and a portion of SC. Travel up to 50% within the territory. The candidate must be domiciled within the territory.

KEY TASKS AND RESPONSIBILITIES

Extensive disease state/therapy space experience (specific to Company Programs/Therapies)
Govt, National and local Commercial Payer experience, State Medicaid, and Managed Plans
Experience in educating and supporting Prior Authorization process, appeals, and denials
Covermymeds – portal access experience a plus
Proactive education - Access Services by Company
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.

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 Company 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.

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Sirius Technical Services, Inc.

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