• Reimbursement Business Manager - Central Region

    Job Locations US-Remote
    Job ID
    2018-1435
    Category
    Commercial
  • Overview

    The Reimbursement Business Manager (RBM) is responsible for unimpeded patient access to Provenge within the assigned geographical area. The RBM will develop and implement strategies that will maximize business opportunities for growth. This position works with medical practice decision makers ,CFO’s, CEO’s, pharmacy and medical directors, purchasing departments, key stake holders within community based urology and oncology practices along with academic and community based hospitals, medical centers, clinics, etc. to effectively reduce reimbursement barriers. The alignment for this territory ND, SD,IN, OH, MN, NE, IA, MO, KS, WI, MI, IL, OK, and AR.

     

    Ideal locale for candidate is near a major airport within the any one of the above listed states.

     

    Responsibilities

    • Removes reimbursement barriers by providing resources and creates access to Provenge, related to coverage and coding.
    • Provides market place feedback in a timely manner to corporate leadership team on customer coverage and reimbursement trends, competitive updates and industry issues and opportunities.
    • Educates providers on patient assistance programs and other resources.
    • Updates and educates accounts on key Commercial and Government  payer policies that may impact access to treatment with Provenge.
    • Assists members of sales force in all aspects of PROVENGE coverage, coding and reimbursement, including access, pull-through, Key Opinion Leaders (KOL) and champion development as it relates to coverage, coding and reimbursement.
    • Develops strategies for removing reimbursement barriers and effectively educates customers to increase reimbursement confidence.
    • Serves as a resource to accounts and Dendreon staff regarding local, regional and national payer policies; reimbursement regulations and processes (i.e., eligibility and benefit verification, pre-authorization, billing, coding, claims, and appeals/grievances); practice management; Medicare and Medicaid rules and regulations; HIPAA.
    • Acts as the liaison between LASH and internal/external customers on all aspect of coverage coding and reimbursement.
    • Complies with all OIG / FDA and corporate policies and procedures.

    Qualifications

    • BA or BS degree required. MBA or advanced degree preferred.
    • Minimum of 5 years’ experience in the pharmaceutical/biotech/life-sciences industry including 3-5 years healthcare coverage, coding, and/or reimbursement experience required.
    • Experience in oncology/urology specialty is preferred.
    • Experience working in the buy and bill area of reimbursement is required.
    • Must process an in-depth understanding of coding, coverage and reimbursement across all sites of care (community, academic, hospital, IDN) and the ability to apply this knowledge to address individual customer concerns.
    • Broad knowledge of Medicare, Medicaid, Managed Care, Third Party payers is required.
    • High level of sophistication/interpersonal skills needed to interact with practice administrators, CEO, CFO, Pharmacy and Medical Directors.
    • The Reimbursement Business Manager will cover multiple regions and thus significant overnight travel is required, estimated at 60%.

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