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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in oncology and hematology-oncology, with a strong understanding of reimbursement dynamics, coding, and billing processes. Proven ability to educate healthcare professionals on patient support programs and establish relationships with providers while managing accounts effectively.
Highest-signal resume keywords
Oncology ExperienceMedical Benefit ReimbursementCoding and Billing RequirementsPayer Policy UnderstandingAccount Management Skills
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Patient Support Program OperationsPrior AuthorizationClaims SubmissionBenefit VerificationAffordability SupportPayer IssuesCoding ChangesSpecialty DistributionBuy-and-Bill ProductsCoverage Requirements
Soft Skills
Territory ManagementRelationship BuildingCollaborationCommunication
Certifications & Qualifications
HCIR Credentialing
Industry Keywords
OncologyHematology-OncologyManaged CareSpecialty Pharmacy NetworksPayer TrendsHealthcare Professionals EducationAccess and ReimbursementField-Based RepresentativeMedicare Parts A, B, C, and DComplex Access Models
About the role
Key responsibilities & impact- Educate healthcare professionals on patient support programs, access and reimbursement support tools, and services
- Educate providers on product-specific acquisition and access options, including specialty pharmacy networks, specialty distribution, and white-bagging support
- Educate providers on resources available to address access issues
- Provide local expertise on national and regional payer policies, payer issues, coding changes, and appropriate claims submission processes
- Collaborate with Oncology internal stakeholders for key account management
- Report payer trends for approved products to Patient Services and MHC account management teams
- Establish and maintain relationships with appropriate providers within the territory
- Remain current on managed care, reimbursement, and policy activities
- Operate as a field-based representative within the assigned territory
Requirements
What you’ll need- Oncology and/or hematology-oncology experience strongly preferred
- Experience with physician-administered therapies, buy-and-bill products, medical benefit reimbursement, specialty distribution/pharmacy, or complex access models strongly preferred
- Demonstrated understanding of coverage, coding, billing, reimbursement, benefit verification, prior authorization, appeals, claims submission, payer policy, affordability support, and patient support program operations
- Strong understanding and ability to communicate technical elements of coding and billing requirements at the national and regional level across all settings of care
- Comprehensive understanding of Medicare Parts A, B, C, and D and associated reimbursement dynamics
- Must satisfy all applicable HCIR credentialing requirements and be in good standing and/or eligible to obtain these credentials
- Excellent territory and account management skills
- Bachelor's degree
- Valid driver's license
- 5 or more years of industry experience in access and reimbursement or account management preferred
- Extensive experience educating others on payer processes, coverage requirements, and access-related situations for specialty medicines preferred
- Strong track record of leadership within current role preferred
- Must live within a reasonable distance from the primary city
- Willingness to travel 75% of the time
Benefits
Comp & perks- Paid time off (vacation, holidays, sick)
- Medical, dental, and vision insurance
- 401(k)
- Long-term incentive programs
- Equal opportunity employer
- Reasonable accommodation support for US and Puerto Rico applicants
