Field Reimbursement Manager, Northeast

Overview

The Field Reimbursement Manager (FRM) will report to the Sr. Director of Field Reimbursement on the Market Access Team. The FRM will be primarily responsible for the overall reimbursement process which will require collaboration between the field sales force, market access team and patient support services. The FRM will not interact with the patient directly.

Northeast Region is responsible for coveing the following geographies:  New England, Upstate NY/CT, Virginia, Washington DC, NYC, Philadelphia

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.