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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 support 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
CodingBillingReimbursementBenefit VerificationPrior AuthorizationClaims SubmissionPayer PolicyAffordability SupportPatient Support Program OperationsMedicare Parts A, B, C, and D
Soft Skills
Territory ManagementAccount ManagementCommunication SkillsLeadership
Certifications & Qualifications
Health Care Industry Representative Credentialing
Industry Keywords
Specialty PharmacySpecialty DistributionBuy-and-Bill ProductsAccess ModelsPayer Trends
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 providers on resources addressing 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
- Work as a field-based representative within a reasonable distance of 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 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 of and ability to communicate technical coding and billing requirements at national and regional levels across all settings of care
- Comprehensive understanding of Medicare Parts A, B, C, and D and associated reimbursement dynamics
- Must satisfy all applicable health care industry representative credentialing requirements and be in good standing and/or eligible to obtain them
- 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 be willing to travel 75% of the time
Benefits
Comp & perks- Paid time off, including vacation, holidays, and sick leave
- Medical, dental, and vision insurance
- 401(k)
- Eligibility to participate in long-term incentive programs
- Remote work option
- Equal opportunity employer commitment
- Reasonable accommodation support for US and Puerto Rico applicants