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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 providers on access and reimbursement support tools while managing key accounts effectively.
Highest-signal resume keywords
Oncology ExperienceHematology-Oncology ExperienceMedical Benefit ReimbursementPayer Policy UnderstandingAccount Management Skills
About the role
Key responsibilities & impact- Educate healthcare providers 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 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 on 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
- Travel approximately 50% of the time
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 preferred
- Understanding of coverage, coding, billing, reimbursement, benefit verification, prior authorization, appeals, claims submission, payer policy, affordability support, and patient support program operations
- Ability to communicate technical coding and billing requirements at national and regional levels across all settings of care
- Understanding of Medicare Parts A, B, C, and D and associated reimbursement dynamics
- Must satisfy applicable HCIR credentialing requirements and be in good standing and/or eligible to obtain credentials
- May require background checks, drug screens, immunization/vaccination proof, fingerprinting, and specific state or city licenses
- 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
- 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
Benefits
Comp & perks- Paid time off (vacation, holidays, sick)
- Medical, dental, and vision insurance
- 401(k)
- Eligibility to participate in long-term incentive programs
- Remote work option
- Equal opportunity employer
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Coding ChangesClaims Submission ProcessesBenefit VerificationPrior AuthorizationAppealsAffordability SupportPatient Support Program OperationsSpecialty DistributionSpecialty Pharmacy NetworksBuy-And-Bill Products
Soft Skills
Communication SkillsRelationship BuildingTerritory ManagementLeadership Skills
Certifications & Qualifications
HCIR Credentialing
Industry Keywords
Managed CarePayer IssuesAccess IssuesHealthcare ProvidersPatient Services