$80K - $100K(Ladders Estimates)
Field Reimbursement Manager: The territory will cover the Pacific Northwest region.
The Field Reimbursement Manager is part of the Market Access group supporting Sun's family of branded products in the United States. This primary goal of this role is to support appropriate patient access to care through education of healthcare provider customers as well as internal sales colleagues and managing individual patient cases through to fulfillment of prescription. Educational components include reimbursement (coverage, coding & payment), specialty pharmacy processes, provider support services (e.g., benefits investigation) and patient support resources (e.g., copay assistance programs, patient assistance programs) The person in this role will monitor national and local healthcare payer policies, develop relationships with key advocacy leaders, state societies, and provide direct support to prescribing physicians, hospitals and support staff regarding reimbursement and patient access issues.
The Field Reimbursement Manager will execute local market plans to support field based priorities and manage and triage local health policy, reimbursement, billing / coding, and patient access issues. Field Reimbursement Managers will collaborate with his / her field partners to alleviate reimbursement and access issues impacting physician offices and the ability of patients to access Sun portfolio of products. The Field Reimbursement Manager will interact with access services hub, managed markets team supporting patient access and local field sales teams. The person in this role with have expertise in access and reimbursement issues encompassing coverage, coding and payment guidelines according to payor policy, sites of care, understanding of coding guidelines (CPT/J-Code/ICD-10), statutory or commercial pricing structures or mandates, and quality programs related to value based care and clinical care pathways.
Education: A minimum of a Bachelor's Degree is required.
Experience: 5 or more years of healthcare industry experience required. A minimum of 3 years' experience in the healthcare industry including but not limited to, insurance verification and / or claim adjudication, physician office and outpatient billing, medical benefit procurement and adjudication within Commercial and Government payers…IE All parts of Medicare, Tricare , Medicaid and National and Regional Commercial payers. This position requires up to 80% travel. Experience working in dermatology and/or oncology is preferred.
• Proven teamwork and collaboration skills with a demonstrated track record of working in highly matrixed and cross-functional work teams
• Applies appropriate interpersonal styles and communications methods to influence and build effective relationships with business partners.
• Able to effectively manage competing priorities with strong sense of urgency.
• Able to act as an articulate advocate for the market access team
Valid Through: 2019-11-1