Field Reimbursement Manager, CAR-T

• Serve as the primary field-based lead for education, assistance, and issue resolution regarding CAR-T reimbursement
• Spend up to 75% of time potentially on-site with customers assessing education needs and facilitating stakeholder collaboration
• Educate office staff on access and payer approval processes, access barriers, and actions supporting therapy access
• Monitor, analyze, and triage situations that may adversely impact patient access to therapy
• Liaise with Market Access, sales, medical, and other internal groups to identify and resolve patient-access issues
• Serve as subject matter expert on Medicare treatment guidelines, Medicaid Managed Care, commercial plans, policy changes, formulary status, and healthcare reform impacts on coverage
• Maintain and share account contacts, prior authorization requirements, trends, and competitive intelligence with the Market Access Department
• Educate Customer Care Area peers on Market Access, reimbursement, medical coverage policies, and medical benefit design
• Conduct business according to ethical, legal, and compliance standards and complete required training

Requirements

• A minimum of a Bachelor’s degree is required
• Five years of relevant experience, including three years in specialty disease state(s)
• Must live within the assigned geographic region; candidates in other states may be considered
• Extensive technical knowledge of payer policy and reimbursement, including coding, coverage, and payment
• Extensive experience in revenue cycle, buy-and-bill, formulary, prior authorization, coding, and appeals processes
• Must live in close proximity to a major airport
• Valid Driver's License issued in the United States
• Advanced degree or clinical license preferred
• Two years of reimbursement or relevant managed care experience preferred
• Experience in multiple myeloma or related oncology areas preferred
• Knowledge of payer approval processes and business acumen
• Strong organizational, problem-solving, and project management skills
• Understanding of national and state legislative, Medicare, Medicaid, and private payer initiatives affecting pharmaceutical and biotechnology reimbursement
• Salesforce. com CRM, native i OS apps, Microsoft Word, and Excel proficiency
• Superior written and verbal communication skills and excellent follow-through
• Experience in field-based reimbursement and oncology preferred
• Ability to develop and execute education plans
• Demonstrated ability to conduct field-based reimbursement and access support, education, and consultation
• Commitment to learning and applying emerging technologies such as AI
• Ability to obtain and maintain access to a national airport
• Core Competencies

Demonstrates extensive knowledge of payer policy and reimbursement processes, including coding, coverage, and payment, while effectively educating stakeholders on access barriers and facilitating collaboration.

Proven ability to analyze and resolve patient access issues in compliance with ethical and legal standards.

• Highest-signal resume keywords
• Payer Policy Expertise
• Reimbursement Processes
• Field-Based Education
• Oncology Knowledge
• Project Management Skills
• ATS Optimization Keywords
• Hard Skills
• Coding
• Coverage
• Payment
• Revenue Cycle Management
• Prior Authorization
• Appeals Processes
• Market Access
• Healthcare Reform Knowledge
• Patient Access Support
• Education Plan Development
• Soft Skills
• Organizational Skills
• Problem‑Solving Skills
• Communication Skills
• Follow-Through
• Collaboration

Certifications & Qualifications

• Bachelor's Degree
• Advanced Degree or Clinical License (Preferred)
• Industry Keywords
• CAR-T Reimbursement
• Medicare Treatment Guidelines
• Medicaid Managed Care
• Commercial Plans
• Formulary Status
• Pharmaceutical Reimbursement
• Biotechnology Reimbursement
• Specialty Disease States
• Multiple Myeloma
• Managed Care Experience
• Tools & Technologies
• Salesforce. com CRM
• Microsoft Word
• Microsoft Excel
• Native i OS Apps
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