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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 providers on access and reimbursement tools while managing key accounts effectively.
Highest-signal resume keywords
Oncology ExperienceHematology-Oncology ExperienceMedical Benefit ReimbursementPayer 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
Coding ChangesClaims SubmissionBenefit VerificationPrior AuthorizationPatient Support Program OperationsPayer IssuesAffordability SupportSpecialty DistributionBuy-and-Bill ProductsPhysician-Administered Therapies
Soft Skills
Communication SkillsRelationship BuildingLeadership SkillsTerritory ManagementCollaboration
Certifications & Qualifications
HCIR Credentialing
Industry Keywords
Managed CareReimbursementPayer TrendsAccess IssuesSpecialty Pharmacy NetworksField-Based RoleHealthcare ProvidersCoding RequirementsMedicare Parts A, B, C, and DTravel Willingness
About the role
Key responsibilities & impact- Educate healthcare providers on patient support programs, access and reimbursement 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 addressing access issues
- Provide local expertise on national and regional payer policies, payer issues, coding changes, and 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
- Work in a field-based role within a reasonable distance from the primary city
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 care settings
- 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 required 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
- Experience educating others on payer processes, coverage requirements, and access-related situations for specialty medicines preferred
- Strong leadership track record preferred
- Willingness/ability to travel 50% of the time
Benefits
Comp & perks- Paid time off (vacation, holidays, sick)
- Medical, dental, and vision insurance
- 401(k)
- Long-term incentive programs
- Potential bonus, commission, incentive, and other compensation benefits at the Company's discretion
