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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 focus on patient support programs, reimbursement processes, and payer policies. Proven ability to educate healthcare professionals on complex access models and maintain relationships with providers while managing 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 AuthorizationAppeals ProcessAffordability SupportPatient Support Program OperationsCoverage RequirementsSpecialty DistributionBuy-and-Bill Products
Soft Skills
Communication SkillsRelationship BuildingLeadership SkillsTerritory ManagementCollaboration
Certifications & Qualifications
HCIR Credentialing
Industry Keywords
Managed CarePayer IssuesOncologyHematologySpecialty Pharmacy NetworksAccess IssuesReimbursement DynamicsMedicare Parts A, B, C, DPatient ServicesAccount Management
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 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
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 settings of care
- Comprehensive understanding of Medicare Parts A, B, C, and D and associated reimbursement dynamics
- Must satisfy all 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 situations for specialty medicines preferred
- Strong track record of leadership within current role preferred
- Willingness to travel 75% of the time
Benefits
Comp & perks- Paid time off (vacation, holidays, sick)
- Medical, dental, and vision insurance
- 401(k)
- Long-term incentive program eligibility
- Reasonable accommodation support
- Equal opportunity employment
