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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 ExpertiseAccount Management SkillsHCIR Credentialing
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 VerificationPayer Policy UnderstandingCoverage RequirementsSpecialty DistributionBuy-and-Bill ProductsPayer Trends ReportingMedicare Parts A, B, C, and D
Soft Skills
Communication SkillsTerritory ManagementRelationship BuildingLeadership
Certifications & Qualifications
Bachelor's DegreeValid Driver's License
Industry Keywords
OncologyHematology-OncologyManaged CareReimbursementAccess ModelsSpecialty Medicines
About the role
Key responsibilities & impact- Educate healthcare professionals on patient support programs, access and reimbursement support tools, and services
- Educate 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 multiple 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
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
- Comprehensive 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
- 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
- Ability to travel 75% of the time
Benefits
Comp & perks- Paid time off (vacation, holidays, sick)
- Medical, dental, and vision insurance
- 401(k)
- Eligibility to participate in long-term incentive programs
- Travel compensation may apply
