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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 processes, coding, and patient support programs. Proven ability to educate healthcare professionals and manage accounts effectively within the healthcare industry.
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 SubmissionPatient Support Program OperationsCoverage RequirementsPayer IssuesSpecialty Distribution
Soft Skills
Communication SkillsRelationship BuildingTerritory ManagementLeadership
Certifications & Qualifications
Health Care Industry Representative Credentialing
Industry Keywords
Managed CarePayer TrendsSpecialty Pharmacy NetworksBuy-and-Bill ProductsAccess ModelsMedicare Parts A, B, C, DField-Based RepresentativeAccount ManagementPatient ServicesAccess Issues
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 on resources available to address 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
- 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
- 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 health care industry representative (HCIR) credentialing requirements and be in good standing and/or eligible to obtain 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 situations for specialty medicines preferred
- Strong track record of leadership within current role preferred
- Ability to live within a reasonable distance from the primary city or one of the listed cities
- Willingness to travel 50% 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
- Reasonable accommodations for US and Puerto Rico applicants
- Equal opportunity employment