Sr Field Reimbursement Manager-East

Replimune Group; Woburn (MA); On-site; USD 181,000 - 234,500; Full time

Benefits offered by this job

Annual performance incentive bonus

New hire equity

Ongoing equity grants

Medical, dental, and vision insurance

401k match

Flexible time off

Paid holidays

Job summary

Replimune Group, a cancer therapies company based in the United States, seeks a Senior Field Reimbursement Manager to lead the reimbursement process across the Eastern US. The role collaborates with field sales, market access, and patient support services, and requires field-based work residing in the territory.

The candidate will navigate clinical policies, coding guidelines, prior authorization, and payer dynamics to support FDA-approved products, with extensive interaction across teams and

Qualifications

• Five (5) + years of reimbursement experience, preferably in oncology Buy and Bill settings.
• Comprehensive knowledge of payers in the US health care system (Medicare, Commercial, Medicaid).
• Proven track record in product reimbursement and coding, preferably in Oncology.
• Strong knowledge of market access, patient access and support services.
• Ability to develop working relationships across teams to achieve goals.

Responsibilities

• Gain understanding of clinical policies, coding guidelines, and prior authorization protocols.
• Identify and resolve reimbursement issues with Director of National Accounts – Payers.
• Inform Field Sales on reimbursement hurdles in territory.
• Use approved tools to support smooth patient journey.
• Manage reimbursement challenges via a defined triage process.
• Collaborate with Director of National Accounts – Payer team on policies for FDA-approved products.
• Communicate with Market Access account team on payer-based medical policies.
• Assist in building, tracking and reporting on KPIs.
• Collaborate with other Field Reimbursement Managers on best practices.
• Advise on development of tools for field reimbursement.
• Update Director on status of approvals and reimbursement.

Skills

Reimbursement exp

Oncology focus

Payer policies

Stakeholder comms

Cross-functional

Education

Bachelor's degree

Tools

Billing systems

Coding guidelines

Market access dashboards

Job description

Overview

Replimune’s mission is to revolutionize cancer treatment with therapies designed to activate a powerful and durable full-body anti-tumor response, boldly transforming cancer care because patient’s lives depend on it.

United: We Collaborate for a Common Goal.

Audacious: We Are Bold.

Dedicated: We Give Our Full Commitment.

Candid: We Are Honest With Each Other.

People are at the center of everything we do, and when it comes to our employees, we make it personal. With a deep sense of purpose, a strong and evolving culture, a competitive and forward-looking total rewards program, everyone at Replimune has a unique opportunity to impact on the lives of patients, caregivers and themselves.

Join us, as we reshape the future.

Job Summary:

The Senior Field Reimbursement Manager (FRM) will report to the Market Access Director of National Accounts – Payers on the Market Access Team. The FRM will be primarily responsible for the overall reimbursement process which will require collaboration between the field sales force, market access team, and patient support services. The FRM will not interact with the patient directly.

This is a field-based position. Candidates must reside within the territory for which they are applying. This position will initially be responsible for the Eastern US market area.

• Gain a firm understanding of the clinical policies, coding guidelines, prior authorization protocol required to prescribe and process billing for FDA approved products.

• Quickly identify, communicate and resolve outstanding billing reimbursement issues to the Director of National Accounts – Payers.

• Inform Field Sales Team of reimbursement hurdles specific to their territory with respect to Replimune Compliance guidelines.

• Use approved materials and suggest any material updates needed to the Market Access team marketer.

• Manage reimbursement challenges through a well-defined triage process.

• Partner with the Director of National Accounts – Payer team on a routine basis to understand the clinical policies for Replimune FDA approved products.

• Use approved tools, such as dashboards, coding guides, etc., to assist in making a smooth and efficient overall patient journey.

• Proactively communicate with Market Access account team to gain a complete understanding of payer based medical policies and clinical criteria for use of FDA approved Replimune products.

• Assist in building, tracking and reporting on key performance indicators to monitor overall performance.

• Collaborate with other field reimbursement managers to implement best practices.

• Advise in the development of tools to be used in the field to assist in product reimbursement.

• Conduct updates to the Director of National Accounts – Payers on the status of approval and reimbursement for patients of FDA approved products.

Education:

• College Degree Required

Required Experience:

• Five (5) + years or relevant reimbursement experience preferably in oncology “Buy and Bill” settings, including community and academic center environments.

• Comprehensive knowledge and understanding of the payers in the US health care system, including Medicare, Commercial, Medicaid and other payer archetypes.

• Proven track record in product reimbursement and coding, preferably in Oncology, with the melanoma therapeutic area a plus.

• Strong knowledge of market access, patient access and support services, with an emphasis on payer and provider reimbursement.

• Demonstrated ability to develop working relationships with other teams to achieve a common goal.

• Strong organizational alignment around prioritization and focus to meet set goals.

• Ability to communicate with customers and stakeholders in a professional manner to build trust and credibility with health care providers.

• Travel as required to assist in the overall reimbursement process.

Salary Range

Replimune is committed to fair and equitable compensation practices, and we strive to provide employees with total compensation packages that are market competitive. For this role, the anticipated base pay range is $181,000-$234,500The exact base pay offered for this role will depend on various factors, including but not limited to the selected candidate’s unique set of qualifications, skills, and experience. Our current organizational needs also play a part in determining your final offer.

At Replimune, base pay is only one part of your total compensation package. The selected candidate will be eligible for an annual performance incentive bonus, new hire equity, and ongoing performance-based equity. Replimune also offers various benefits offerings, including, but not limited to, medical, dental, and vision insurance, 401k match, flexible time off, and a number of paid holidays including year-end shutdown.

• annual performance incentive bonus
• new hire equity
• ongoing performance-based equity
• medical, dental, and vision insurance
• 401k match
• flexible time off
• a number of paid holidays including year-end shutdown

About Replimune

Replimune Group, Inc., headquartered in Woburn, MA, was founded in 2015 with the mission to transform cancer treatment by pioneering the development of a novel portfolio of oncolytic immunotherapies. Replimune’s proprietary RPx platform is based on a potent HSV-1 backbone intended to maximize immunogenic cell death and the induction of a systemic anti-tumor immune response. The RPx platform is designed to have a unique dual local and systemic activity consisting of direct selective virus-mediated killing of the tumor resulting in the release of tumor derived antigens and altering of the tumor microenvironment to ignite a strong and durable systemic response. The RPx product candidates are expected to be synergistic with most established and experimental cancer treatment modalities, leading to the versatility to be developed alone or combined with a variety of other treatment options. For more information, please visit www.replimune.com.

We are an Equal Opportunity Employer.