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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 thorough understanding of payer policies, coding requirements, and reimbursement dynamics for specialty medicines. Proven ability to educate healthcare providers and manage relationships effectively within the assigned territory.
Highest-signal resume keywords
Managed Health Care ExperiencePayer Account ManagementAccess and Reimbursement ExpertiseTerritory Management SkillsBachelor’s Degree
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Reimbursement Support ServicesCoding and Billing RequirementsMedicare Parts A, B, C, and DPayer Policy ProcessesClaims Submission Processes
Soft Skills
Relationship BuildingCommunication SkillsProblem-Solving Skills
Tools & Technologies
Patient Support ProgramsSpecialty Pharmacy NetworksSpecialty Distribution
Certifications & Qualifications
Valid Driver’s LicenseHCIR Credentialing Requirements
Industry Keywords
Patient AccessReimbursement ChallengesManaged CarePayer PoliciesAccess Issues
About the role
Key responsibilities & impact- Serve as an alternative in-office resource addressing HCP questions about patient access
- Call directly on HCP offices within the assigned geography
- Answer questions about patient access and reimbursement for Duopa, Vyalev, and Juvmo
- Provide expertise on coverage and common access and reimbursement challenges affecting specialty medicines
- Educate HCPs on patient support programs and access and reimbursement tools
- Educate on product-specific acquisition and access options, including specialty pharmacy networks and specialty distribution
- Provide resources to address access issues
- Explain national and regional payer policies, payer issues, coding changes, and claims submission processes
- Liaise with AbbVie’s Access and Reimbursement support center regarding 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 coverage, coding, and payment for specialty medicines
- Understanding of 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
- Valid driver’s license
- Ability to pass a pre-employment drug screening test and meet safe driving requirements
- Ability to satisfy applicable HCIR credentialing requirements, including potential background checks, drug screens, immunization/vaccination proof, fingerprinting, and specific licenses
- Ability to live within a reasonable distance from the primary city in Colorado
- 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 programs
- Company car or truck may be used for work
- Comprehensive benefits package
