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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in Managed Health Care and Access and Reimbursement, with a strong understanding of payer policies, coding, and reimbursement dynamics. Capable of effectively educating healthcare providers on patient access programs and maintaining relationships within the territory.
Highest-signal resume keywords
Managed Health Care ExperiencePayer Account ManagementAccess And Reimbursement KnowledgeTerritory Management SkillsMedicare Reimbursement Understanding
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Payer Policy ProcessesCoding RequirementsClaims Submission ProcessesPatient Support ProgramsSpecialty Pharmacy NetworksReimbursement ToolsAccess Issues ResolutionTechnical CommunicationHealthcare RegulationsReimbursement Dynamics
Soft Skills
Relationship BuildingCommunication SkillsProblem-Solving SkillsAccount ManagementTerritory Management
Certifications & Qualifications
HCIR Credentialing RequirementsValid Driver's License
Industry Keywords
Managed CarePayer PoliciesSpecialty Medicine CoverageMedicare Parts A, B, C, DAccess And Reimbursement Services
About the role
Key responsibilities & impact- Act as an alternative in-office resource addressing HCP questions about patient access
- Call directly on HCP offices within the assigned geography
- Support Duopa, Vyalev, and Juvmo access and reimbursement
- Educate HCPs on patient support programs, access and reimbursement tools, and services
- Educate on product-specific acquisition and access options, including specialty pharmacy networks and specialty distribution
- Advise HCPs on resources for addressing access issues
- Provide local expertise on national and regional payer policies, coding changes, and claims submission processes
- Liaise with AbbVie’s Access and Reimbursement support center on prescription status and program eligibility
- Report payer trends for approved products to Patient Services and MHC account management teams
- Establish and maintain relationships with providers within the territory
- Remain current on managed care, reimbursement, and policy activities
Requirements
What you’ll need- At least 3 years of experience in Managed Health Care, Payer Account Management, and/or Access and Reimbursement
- Understanding of rules, regulations, and risks associated with reimbursement support services
- Thorough understanding of technical payer policy processes, systems, and requirements for specialty medicine coverage, coding, and payment
- 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
- Excellent territory and account management skills
- Bachelor's degree
- Personal auto, company car or truck, or powered material-handling equipment
- Valid driver's license
- Ability to pass pre-employment drug screening and meet safe driving requirements
- Must satisfy applicable HCIR credentialing requirements and be in good standing and/or eligible to obtain credentials, which may include background checks, drug screens, immunization/vaccination proof, fingerprinting, and specific licenses
Benefits
Comp & perks- Paid time off (vacation, holidays, sick)
- Medical, dental, and vision insurance
- 401(k)
- Eligibility to participate in long-term incentive programs
- Resources to answer questions regarding HCIR credentialing responsibilities
