FIELD REIMBURSEMENT MANAGER - Northwest
Full TimeProfessional
Requisition ID: 1096
Salary Range:$140,000.00 To 165,000.00 Annually
About Blue Earth Diagnostics:
Blue Earth Diagnostics is an established molecular imaging company focused on providing innovative, well-differentiated diagnostics solutions, informing patient management, and driving future therapies in cancer. Formed in 2014, Blue Earth Diagnostics’ success is driven by our management expertise and agility, supported by our demonstrated track record of rapid development and commercialization of PET radiopharmaceuticals. Blue Earth Diagnostics’ clinical focus is exclusively in cancer. Blue Earth Diagnostics is a subsidiary of Bracco Imaging S.p.A., a global leader in diagnostic imaging.
About the Role:
Reporting to the Director, Patient Access, the Field Reimbursement Manager is critical to ensuring the reimbursement of novel diagnostic radiopharmaceuticals. The scope of the role includes working directly with customers, both imaging sites and referring physician offices, to serve as an expert in payer policies and provide support to facilitate appropriate patient access.
The ideal candidate will bring his or her previous customer experience and relationships into a setting that has a strong existing reimbursement foundation with Medicare, Medicare Advantage and commercial payer coverage. They also will enable customers to successfully gain prior authorization approvals and coverage for appropriate patient scans, in addition to providing hands-on education, and supporting the field sales teams.
Key success factors for this role include experience and competence in relationship building, concise presentation of complex healthcare policy and reimbursement information, and the ability to quickly identify solutions to address both customer and business needs.
Main Responsibilities, Activities, Duties and Tasks
Full TimeProfessional
Requisition ID: 1096
Salary Range:$140,000.00 To 165,000.00 Annually
About Blue Earth Diagnostics:
Blue Earth Diagnostics is an established molecular imaging company focused on providing innovative, well-differentiated diagnostics solutions, informing patient management, and driving future therapies in cancer. Formed in 2014, Blue Earth Diagnostics’ success is driven by our management expertise and agility, supported by our demonstrated track record of rapid development and commercialization of PET radiopharmaceuticals. Blue Earth Diagnostics’ clinical focus is exclusively in cancer. Blue Earth Diagnostics is a subsidiary of Bracco Imaging S.p.A., a global leader in diagnostic imaging.
About the Role:
Reporting to the Director, Patient Access, the Field Reimbursement Manager is critical to ensuring the reimbursement of novel diagnostic radiopharmaceuticals. The scope of the role includes working directly with customers, both imaging sites and referring physician offices, to serve as an expert in payer policies and provide support to facilitate appropriate patient access.
The ideal candidate will bring his or her previous customer experience and relationships into a setting that has a strong existing reimbursement foundation with Medicare, Medicare Advantage and commercial payer coverage. They also will enable customers to successfully gain prior authorization approvals and coverage for appropriate patient scans, in addition to providing hands-on education, and supporting the field sales teams.
Key success factors for this role include experience and competence in relationship building, concise presentation of complex healthcare policy and reimbursement information, and the ability to quickly identify solutions to address both customer and business needs.
Main Responsibilities, Activities, Duties and Tasks
- Provide expert guidance to imaging sites to ensure accurate claims submission, best practices sharing for prior authorization and appeals, scheduling tips, understanding of reimbursement landscape, liaise providers with payers where appropriate
- Educate and support referring physician offices with best practice sharing for prior authorizations and appeals, coverage landscape of Blue Earth Diagnostics’ products
- Develop and maintain relationships with identified key customers
- Provide Payer Relations Managers with field updates on specific payer challenges; connect potential payer key opinion leaders; and communicate day-to-day learnings that may assist the payer team in their activities
- Perform quarterly reviews with assigned customers to provide ongoing support and uncover payer issues; escalate payer issues to Payer Relations Manager
- Coordinate with reimbursement support line consultants, where appropriate, to provide updates, guidance, and address challenges with reimbursement as reported by users
- Provide regular status reports and tracking of customer education/interaction and results
- Identify and maintain administrative advocate relationships
- Work collaboratively with other functional areas to ensure regional customer reimbursement support
- Other projects as determined by the Director, Patient Access
- Other duties as determined by business needs.
- Bachelor’s degree preferred with 3-5 years working in provider relations, market access roles with knowledge of coverage and reimbursement. In place of a bachelor’s degree, 5+ years of relevant experience will be accepted.
- Field based role. Ability to work effectively and independently from a home office
- Must be able to travel as needed (up to 50% of the time)
- Desired 3-years minimum demonstrated experience and success in healthcare industry, preferably imaging, diagnostics, or pharmaceuticals
- Ability to work directly with hospitals/independent imaging centers and referring physician practices on payer specific issues
- Knowledge of medical benefit plan design (Commercial, Medicare, Medicare Advantage)
- Ability to lead/facilitate live training and education
- Organized, highly developed time management skills with demonstrated ability to meet deadlines and handle multiple priorities with a high degree of initiative
- Well-developed analytical, problem solving, and influencing skills, appropriately balanced with strong interpersonal and teaming skills
- Excellent communication (written, verbal, and presentation) skills with ability to interact with all levels of management for both internal and external customer base. Ability to provide virtual and in person training.
- Demonstrated ability to successfully manage high impact relationships and projects
- Proficiency with Microsoft office suite.
- Excellent oral & written communication skills. Ability to influence and build relationships/earn credibility quickly across broad global constituencies with competing priorities.
- Strong coaching, facilitation, and organizational skills; team player. Experience and skills with cross-functional and highly matrixed organizations.