Sirius Technical Services, Inc.
Associate Director- Field Reimbursement- Oncology
Sirius Technical Services, Inc., Orlando, Florida, us, 32885
Associate Director- Field Reimbursement- Oncology
Tampa, FL USPosted: 09/03/2024Job Category: MedicalJob Number: HA4185893Job Title: Associate Director - Field Reimbursement – OncologyJob Location: GA, AL, FL, and SCJob Type: Full-time, Direct HireSalary Range: $144,000- $216,000Travel: Yes, 50%PURPOSE
Responsible for ensuring patient access to oncology products within assigned geographical area via supporting HCPs and Office staff in navigating therapy Prior Authorizations (PAs), Medical Necessity documentation and therapy PA denial appeals. Develop collaborative working partnerships with HCPs and Office Staff, to support Patient access to therapies. This position works with medical practice therapy decision makers, practice clinical administrators, key office support staff and clinical pharmacists to assist with Health Plan/PBM therapy approval requests. This position is also responsible for collaboration with the Company Patient Support Services Team, Market Access Field Teams, Company AGMs, SCs and MSLs to execute reimbursement and access programs to reduce access and affordability hurdles for patients on oncology products. The span of coverage will be GA, AL, FL, and a portion of SC. Travel up to 50% within the territory. The candidate must be domiciled within the territory.KEY TASKS AND RESPONSIBILITIES
Extensive disease state/therapy space experience (specific to Company Programs/Therapies)Govt, National and local Commercial Payer experience, State Medicaid, and Managed PlansExperience in educating and supporting Prior Authorization process, appeals, and denialsCovermymeds – portal access experience a plusProactive education - Access Services by CompanyStay current with local MAC policies and proceduresExcellent verbal and written communication skills as well as prior experience educating providersCollaborating across multiple stakeholdersProactive Problem solving, defusing, and resolving escalations, consistent and timely follow upProven experience in flexibility and adaptability Territory ManagementAbility to engage and navigate HCPs in various settings including hospitals, private practice, large multi-specialty practices, IDNs, IDN out-patient clinics and other facilitiesInitiative-taking business acumen to identify and resolve HCP/Office Staff issues/challenges with Payer/PBM therapy approvalsNew Product / Indications launch experienceMust have a valid driver's license with a safe driving record/ MVRSpecialty Pharmacy ExperienceExperience educating and/or supporting pharmacies.REQUIRED QUALIFICATIONS
Bachelor’s Degree or minimum of 5 years healthcare related reimbursement experience2 + years Field Reimbursement experienceIn depth understanding of Payer/PBM therapy approval requirements (Prior Authorization, Medical Necessity, Denial Appeals, Formulary coverage and payment for oncology therapies across all sites of care (hospital, clinic, integrated delivery network) and ability to apply this knowledge to address individual customer concernsBroad knowledge of Medicare, managed care, third party payers and MedicaidDemonstrated excellence in meeting and exceeding customer expectations especially in demanding situationsAbility to effectively address customer concerns in a timely fashion and by working collaboratively with external and internal stakeholdersAn elevated level of sophistication/people skills needed to interact with practice clinical decision makers, office support staff, clinical pharmacists, and office managersMust demonstrate a comprehensive knowledge of customer relations, therapy formulary coverage, utilization management, and able to interpret complex informationMust possess the leadership ability to effectively organize, communicate and collaborate with HCPs, Key Practice Staff and Company external and internal team membersExceptional knowledge of Healthcare ManagementPharmaceutical Manufacturer federal, state, and local compliance requirementsArea Reimbursement Managers will cover multiple regions, thus significant overnight travel, up to 50%Must have a valid driver's license with a safe driving record/ MVR.PREFERRED QUALIFICATIONS
2 + years Oncology Field Reimbursement ExperienceExperience in oncology and working with key oncology stakeholders.
#J-18808-Ljbffr
Tampa, FL USPosted: 09/03/2024Job Category: MedicalJob Number: HA4185893Job Title: Associate Director - Field Reimbursement – OncologyJob Location: GA, AL, FL, and SCJob Type: Full-time, Direct HireSalary Range: $144,000- $216,000Travel: Yes, 50%PURPOSE
Responsible for ensuring patient access to oncology products within assigned geographical area via supporting HCPs and Office staff in navigating therapy Prior Authorizations (PAs), Medical Necessity documentation and therapy PA denial appeals. Develop collaborative working partnerships with HCPs and Office Staff, to support Patient access to therapies. This position works with medical practice therapy decision makers, practice clinical administrators, key office support staff and clinical pharmacists to assist with Health Plan/PBM therapy approval requests. This position is also responsible for collaboration with the Company Patient Support Services Team, Market Access Field Teams, Company AGMs, SCs and MSLs to execute reimbursement and access programs to reduce access and affordability hurdles for patients on oncology products. The span of coverage will be GA, AL, FL, and a portion of SC. Travel up to 50% within the territory. The candidate must be domiciled within the territory.KEY TASKS AND RESPONSIBILITIES
Extensive disease state/therapy space experience (specific to Company Programs/Therapies)Govt, National and local Commercial Payer experience, State Medicaid, and Managed PlansExperience in educating and supporting Prior Authorization process, appeals, and denialsCovermymeds – portal access experience a plusProactive education - Access Services by CompanyStay current with local MAC policies and proceduresExcellent verbal and written communication skills as well as prior experience educating providersCollaborating across multiple stakeholdersProactive Problem solving, defusing, and resolving escalations, consistent and timely follow upProven experience in flexibility and adaptability Territory ManagementAbility to engage and navigate HCPs in various settings including hospitals, private practice, large multi-specialty practices, IDNs, IDN out-patient clinics and other facilitiesInitiative-taking business acumen to identify and resolve HCP/Office Staff issues/challenges with Payer/PBM therapy approvalsNew Product / Indications launch experienceMust have a valid driver's license with a safe driving record/ MVRSpecialty Pharmacy ExperienceExperience educating and/or supporting pharmacies.REQUIRED QUALIFICATIONS
Bachelor’s Degree or minimum of 5 years healthcare related reimbursement experience2 + years Field Reimbursement experienceIn depth understanding of Payer/PBM therapy approval requirements (Prior Authorization, Medical Necessity, Denial Appeals, Formulary coverage and payment for oncology therapies across all sites of care (hospital, clinic, integrated delivery network) and ability to apply this knowledge to address individual customer concernsBroad knowledge of Medicare, managed care, third party payers and MedicaidDemonstrated excellence in meeting and exceeding customer expectations especially in demanding situationsAbility to effectively address customer concerns in a timely fashion and by working collaboratively with external and internal stakeholdersAn elevated level of sophistication/people skills needed to interact with practice clinical decision makers, office support staff, clinical pharmacists, and office managersMust demonstrate a comprehensive knowledge of customer relations, therapy formulary coverage, utilization management, and able to interpret complex informationMust possess the leadership ability to effectively organize, communicate and collaborate with HCPs, Key Practice Staff and Company external and internal team membersExceptional knowledge of Healthcare ManagementPharmaceutical Manufacturer federal, state, and local compliance requirementsArea Reimbursement Managers will cover multiple regions, thus significant overnight travel, up to 50%Must have a valid driver's license with a safe driving record/ MVR.PREFERRED QUALIFICATIONS
2 + years Oncology Field Reimbursement ExperienceExperience in oncology and working with key oncology stakeholders.
#J-18808-Ljbffr