Field Reimbursement Manager, Midwest

Overview:

The FRM will not interact with the patient directly.

Midwest Region is responsible for coveing the following geographies: Cleveland/Pittsburgh, Illinois/Wisconsin, Indiana/Missouri, Louisville/Cincinnati, Michigan

to be considered for this role, candidates must live in this geography

Responsibilities:

Key responsibilities:

• Collaborate with other field reimbursement managers to identify best practices.
• Advise in the development of tools to be used in the field to assist in product reimbursement.
• Gain a firm understanding of the clinical policies, coding guidelines, prior authorization protocol required to prescribe FDA approved products.
• Conduct daily updates to the Senior Director of Field Reimbursement on the status of approval and reimbursement for patients of FDA approved products.
• Proactively communicate with Market Access account team to gain a complete understand of payer based medical policies and clinical criteria for use of FDA approved Replimune products.
• Quickly identify, communicate and resolve outstanding reimbursement issues to the Senior Director of Field Reimbursement.
• Inform Field Sales Team of reimbursement hurdles specific to their territory.
• Use approved pull-through materials and suggest any needed material updates to the Market Access team marketer.
• Manage reimbursement challenges through a well-defined triage process.
• Partner with the Market Access Director of National Accounts team on a routine basis to understand the clinical policies for Replimune FDA approved products.
• Use approved tools, such as dashboards, coding guides, etc., to assist in making a smooth and efficient overall patient journey.
• Assist in building, tracking and reporting on key performance indicators to monitor overall performance.

Qualifications:

Educational requirements:

College degree required.

Experience and skill requirement:

• Five (5)+ years or relevant experience preferably in oncology “Buy and Bill” reimbursement.
• Comprehensive knowledge and understanding of the payers in the US health care system, including Medicare, Commercial, Medicaid and other payer archetypes.
• Proven track record in product reimbursement and coding, preferably in the melanoma therapeutic area.
• Strong knowledge of market access, patient access and support services, with an emphasis on payer reimbursement.
• Demonstrated ability to develop working relationships with other teams to achieve a common goal.
• Strong organizational alignment around prioritization and focus to meet set goals.
• 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.