Senior Field Reimbursement Manager

🔥 4 minutes ago

🍂 Massachusetts – Remote

🍂 Massachusetts – Remote

💵 $181k - $234.5k / year

⏰ Full Time

🟠 Senior

👔 Manager

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Replimune

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 2015

🧬 Biotechnology

🏥 Healthcare

💊 Pharmaceuticals

💰 $140M Post-IPO Equity - Replimune Group on 2024-11

Biotechnology • Healthcare • Pharmaceuticals

Replimune is a clinical-stage biotechnology company focused on developing a new class of oncolytic immunotherapies intended to activate powerful, durable systemic anti-tumor immune responses. The company’s approach is to kill tumors locally, alter the tumor microenvironment, and ignite a full-body, tumor-specific immune response. Replimune is conducting clinical programs evaluating the safety and effectiveness of its investigational therapies in a range of solid tumors, both as single agents and in combination with other immunotherapies.

📋 Description

• 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.

🎯 Requirements

• 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.

🏖️ Benefits

• medical, dental, and vision insurance • 401k match • flexible time off • paid holidays including year-end shutdown