Field Reimbursement Manager, Oncology

SmartRecruiters, Inc.; Boston (MA); On-site; USD 132,000 - 238,000; Full time

Job summary

AbbVie is seeking a field-based reimbursement and access specialist to educate HCPs on patient support programs and payer policies within the Hartford, CT or Albany, NY region. Travel and HCIR credentialing are required.

Experience in oncology reimbursement, coverage, and complex access models is preferred. Collaboration with oncology teams and providers is essential for successful accounts and payer insights.

Qualifications

• Oncology/hematology-oncology experience preferred with buy-and-bill or complex access models.
• Understanding of coverage, coding, billing, reimbursement, and patient support operations.
• Ability to explain coding and billing requirements at national/regional levels.
• Strong knowledge of Medicare/Medicaid and reimbursement dynamics.
• Meet HCIR credentialing requirements for facilities in the territory.
• Excellent territory and account management skills.
• Valid driver’s license required.

Responsibilities

• Educate HCPs on patient support programs and reimbursement tools.
• Educate on acquisition and access options like specialty networks and distribution.
• Provide local expertise on payor policies to educate providers on payer issues.
• Collaborate with Oncology stakeholders for key account management.
• Report payer trends to Patient Services and MHC teams.
• Establish relationships with providers within the territory.
• Stay current on managed care, reimbursement, and policy activities.

Skills

Oncology experience

Hematology-oncology

Payer policy knowledge

Coding & billing know-how

HCIR credentialing

Territory management

Driver's license

Job description

• Compensation: USD 132,000 - USD 238,000 - yearly

Company Description

About AbbVie

AbbVie's mission is to discover and deliver innovative medicines and solutions that solve serious health issues today and address the medical challenges of tomorrow. We strive to have a remarkable impact on people's lives across several key therapeutic areas including immunology, oncology and neuroscience - and products and services in our Allergan Aesthetics portfolio. For more information about AbbVie, please visit us at www.abbvie.com . Follow @abbvie on LinkedIn, Facebook , Instagram , X and YouTube.

Job Description

This role is field-based, and candidates should live within a reasonable distance from the primary city. Talent will be hired at a level commensurate with experience.

Candidates may live in the following cities:

• Hartford, CT
• Albany, NY

Responsibilities:

• Educate HCPs on patient support programs, including access and reimbursement support tools and services
• Educate on product-specific acquisition and access options such as specialty pharmacy networks, specialty distribution, and white-bagging support
• Educate on resources available to address access issues
• Provide local expertise in regards to national/regional payor policies in order to educate providers on payer issues, coding changes, and appropriate claims submission processes
• Collaborate with multiple Oncology internal stakeholders for key account management.
• Report back payer trends related for approved products to Patient Services and MHC account management teams
• Establish and maintain relationships with appropriate providers within territory
• Remain current on key managed care, reimbursement, and policy activities

Qualifications

• Oncology and/or hematology-oncology experience strongly preferred, including experience with physician-administered therapies, buy-and-bill products, medical benefit reimbursement, specialty distribution/pharmacy, or complex access models.
• Demonstrated understanding of coverage, coding, billing, reimbursement, benefit verification, prior authorization, appeals, claims submission, payer policy, affordability support, and patient support program operations.
• Strong understanding and ability to communicate technical elements of coding and billing requirements at the National and Regional level across all settings of care
• Comprehensive understanding of Parts A, B, C and D or Medicare and associated reimbursement dynamics
• An essential requirement of your position is to satisfy all applicable health care industry representative (HCIR) credentialing requirements to gain and maintain entry into facilities and organizations that are in your assigned territory. You must also be in good standing and/or eligible to obtain these credentials.
• These HCIR credentialing requirements may include, but are not limited to, background checks, drug screens, proof of immunization/vaccination for various diseases, fingerprinting and specific licenses required by individual state or cities. Please remember that you are solely responsible for ensuring that you satisfy all HCIR credentialing requirements and for any associated liability for failing to do so. to AbbVie has resources to answer questions you may have regarding your responsibilities.
• Excellent territory and account management skills
• Valid driver’s license

Preferred Qualifications

• 5 or more years of industry experience in access and reimbursement or account management
• Extensive experience educating others on payer processes, requirement for coverage, and other access related situations for specialty medicines
• Strong track record of leadership within current role

Additional Information

Applicable only to applicants applying to a position in any location with pay disclosure requirements under state orlocal law:

The compensation range described below is the range of possible base pay compensation that the Companybelieves ingood faith it will pay for this role at the timeof this posting based on the job grade for this position.Individualcompensation paid within this range will depend on many factors including geographic location, andwemayultimatelypaymore or less than the posted range. This range may bemodifiedin thefuture.

We offer a comprehensive package of benefits including paid time off (vacation, holidays, sick),medical/dental/visioninsurance and 401(k) to eligibleemployees.

This job is eligible toparticipatein our long-term incentiveprograms.

Note: No amount of payis considered to bewages or compensation until such amount is earned, vested, anddeterminable.The amount and availability of any bonus,commission, incentive, benefits, and any other form ofcompensation and benefits that are allocable to a particular employeeremainsin the Company's sole and absolute discretion unless and until paid andmay bemodifiedat the Company’s sole and absolute discretion, consistent withapplicable law.

AbbVie is an equal opportunity employer and is committed to operating with integrity, driving innovation, transforming lives and serving our community. Equal Opportunity Employer/Veterans/Disabled.

US & Puerto Rico applicants seeking a reasonable accommodation, click here to learn more:

By clicking the link above or any third-party link within this posting, you are leaving this site and going to a third-party website where the third-party website's terms and privacy policy apply