Covance

  • Field Reimbursement Manager - OH. PA

    Job Location(s) US-TX-Austin | US-OH-Cincinnati | US-PA-Pittsburgh
    Job Number
    2018-25126
    Job Category
    Consulting
    Position Type
    Full-Time
  • Job Overview

     

    Covance Market Access Services currently provides health care reimbursement support, access education, and access solutions for pharmaceutical and biopharmaceutical clients with its Market Access Field Team. The Field Reimbursement Manager are client-facing and customer-facing staff who leverage their expertise and experience to assist client customers in understanding and addressing access challenges.  They conduct presentations to small and large groups in various settings and often work face to face with providers’ office staff -- educating staff on access services and solutions specific to a product and therapeutic area, and consulting on reimbursement matters.  These services play an important role in clients’ customer relationships as they facilitate access to important patient therapies.

    *** NOTE:  This position can be filled anywhere in OH or in the Pittsburgh area, PA to cover the North, East of USA. Due to the travel requirements of the job, candidates should live close to a major airport.  

    The Field Reimbursement Manager helps to educate corporate decision-makers and accounts on reimbursement, billing and coding. The FRM will provide education on the barriers to appropriate reimbursement and discuss current billing/coding practices to identify possible opportunities to provide learning. The FRM will work directly with CEO, CMO, Corporate office support staff, LTC billing and coding staff, third party vendors (Reimbursement Support Service), and other important stakeholders. This position will work closely with internal partners, supporting priority accounts through effective account planning/execution. They also develop customer-oriented reimbursement support, and proactively communicate payer criteria/terms, policies and practices, as these relate to reimbursement for the assigned products.

     

    Proactively communicates and explains reimbursement, billing/coding policies, procedures and resources in-person

    • Ability to review clinical trials relevant to long term care arena that may be assigned
    • Operates in compliance with all laws, regulations and policies that govern the conduct of the FRM position
    • Develops long-term & short-term strategic account plans focusing on appropriately educating accounts on reimbursement concepts
    • Educate corporate office staff and assist in developing initiatives to disseminate educational programs on billing/coding/reimbursement to network of nursing homes owned under the corporate entity
    • Develops and shares local market insights with colleagues to better understand barriers impacting access to vaccines
    • Review appropriate billing and coding for products, assist with understanding reimbursement issues, and help ensure appropriate education to avoid future reimbursement hurdles
    • Acts as a subject matter expert on the payer landscape relevant to the assigned vaccine therapeutic area
    • Acts as a conduit between the Field and Home Office Reimbursement functions for all public and private payer policies and practices that impact patient access to vaccines
    • Works with internal partners to understand managed care challenges for vaccines
    • Collaborate with client LTC team, brand team, sales, etc. to identify accounts that would be appropriate accounts to focus efforts
    • Develops ethical and customer-oriented reimbursement tactics
    • Trouble-shoots field account reimbursement issues, needs, concerns, or challenges
    • Majority of time is spent via in-person customer interfacing/engagement
    • Leverages all available resources including internal data to develop and execute account plans/call purpose.
    • Proactively communicates and explains client specific reimbursement programs, policies, procedures and resources
    • Fluent in all vaccines relevant in LTC
    • Provides information on appeals/denials requirements procedures and links to forms
    • Up to 80% Business travel, is regularly required

    Education/Qualifications

    Bachelor's Degree recommended

    5 or more years' work experience in pharmaceutical, medical, LTC, vaccine, and/or practice/hospital reimbursement.  LTC experience highly preferred.

    • A minimum of 2 years of direct experience with managed care and reimbursement is required, either directly within/from the pharmaceutical/biotech industry or relevant, and experience calling on large accounts

    Experience

    Must demonstrate excellent working knowledge of reimbursement and the practice management environment

    • Previous experience in vaccines and products with CPT code is a plus
    • Knowledge of Center's of Medicare & Medicaid Services (CMS) policies and processes with expertise in Medicare Part B & D (Pharmacy Benefit design and coverage policy)
    • Knowledge of nursing home/ long term care space preferred
    • Previous experience in other functions in the vaccine industry is a plus, e.g. product marketing, managed care marketing, field account management, etc.
    • Proven track record for consistently meeting or exceeding goals and objectives
    • Previous experience in completing & implementing attainable account plans

    Have a valid driver's license and a safe driving record and be available to drive during the day and night time. Must live within a reasonable driving distance  from a major airport.

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