Field Reimbursement & Access Manager – Oncology

Dendreon Pharmaceuticals; Kansas City (KS); On-site; USD 90,000 - 130,000; Full time

Job summary

Dendreon Pharmaceuticals seeks a Reimbursement Account Manager to ensure unimpeded patient access to PROVENGE across assigned regions. Develop and implement strategies to maximize growth, navigate national, regional, federal and state Medicaid policies to reduce barriers and improve reimbursement.

You will partner with physicians, payors, and practice leaders in oncology/urology to remove obstacles, educate on coverage and coding, and support the sales team.

Qualifications

• BA or BS degree required; MBA or advanced degree preferred.
• Minimum of 5 years’ experience in the pharmaceutical/biotech/life-sciences industry including 3-5 years healthcare coverage, coding, and/or reimbursement experience.
• Experience in oncology/urology specialty is preferred.
• Experience working in the buy and bill area of reimbursement is required.
• Must understand coding, coverage and reimbursement across all sites of care (community, academic, hospital, IDN).
• Broad knowledge of Medicare, Medicaid, Managed Care, Third Party payors.
• The RAM will cover multiple regions and thus significant overnight travel is required (estimated at 60%).

Responsibilities

• Removes practice reimbursement barriers by providing resources and creates access to PROVENGE, related to coverage and coding.
• Provides market place feedback in a timely manner to corporate leadership team on customer coverage and reimbursement trends, competitive updates and industry issues and opportunities.
• Educates providers on patient assistance programs and other resources.
• Updates and educates accounts on key Commercial and Government payor policies that may impact access to treatment with PROVENGE.
• Assists members of sales force in all aspects of PROVENGE coverage, coding and reimbursement, including access, pull-through, Key Opinion Leaders (KOL) and champion development as it relates to coverage, coding and reimbursement.
• Develops strategies for removing reimbursement barriers and effectively educates customers to increase reimbursement confidence.
• Serves as a resource to accounts and internal Dendreon staff regarding local, regional and national payor policies; reimbursement regulations and processes (i.e., eligibility and benefit verification, pre-authorization, billing, coding, claims, and appeals/grievances); practice management; Medicare and Medicaid rules and regulations; HIPAA.
• Acts as the liaison between LASH and internal/external customers on all aspect of coverage coding and reimbursement.
• Records all Regional Payor Provenge medical policies and contact information in SFDC.
• Complies with all OIG / FDA and corporate policies and procedures.

Skills

Healthcare reimbursement

Buy and bill reimbursement

Oncology/Urology knowledge

Education

BA or BS degree

MBA or advanced degree

Job description

Dendreon Pharmaceuticals seeks a Reimbursement Account Manager to ensure unimpeded patient access to PROVENGE across assigned regions. Develop and implement strategies to maximize growth, navigate national, regional, federal and state Medicaid policies to reduce barriers and improve reimbursement.

You will partner with physicians, payors, and practice leaders in oncology/urology to remove obstacles, educate on coverage and coding, and support the sales team.