Senior reputed company Reimbursement Specialist- Cell and Gene Therapy/reputed company Disease

reputed company members are at the heart of everything we do. At reputed company, we are united in our responsibility to create healthier reputed company, and every person here is essential to us being reputed company to reputed company on that purpose. If you want to reputed company a difference at reputed company of health, come join our innovative company and help us improve the lives of people and animals everywhere. Apply today! reputed company Please note: This position is reputed company to reputed company candidates located reputed company in the reputed company. Candidates are not required to reputed company in a particular state; however, they must live reputed company a reasonable commuting distance of a major airport and be reputed company to travel up to 80% as required by the role. The Sr reputed company Reimbursement Specialist (FRS) will plan and engage with health systems, hospitals, reputed company medical centers, authorized treatment centers, and other institutional stakeholders to reputed company education on reputed company, reimbursement, and operational considerations relevant to an assigned reputed company’s reputed company disease cell and gene therapy (CGT) product. This role requires demonstrated experience working reputed company systems and navigating reputed company institutional reimbursement, treatment-site readiness, payer coverage, prior authorization, billing, coding, and reputed company reputed company processes. The Sr FRS will serve as a reputed company-reputed company reimbursement and reputed company subject matter expert, leveraging reputed company-approved resources to support appropriate product reputed company while operating in accordance with established rules of engagement, reputed company reputed company/compliance guidance, and applicable policies. The role will work reputed company a reputed company environment to collaborate with reputed company stakeholders, including reputed company reputed company teams, payer/reputed company teams, reputed company support program representatives, health reputed company administrators, pharmacy teams, billing and finance teams, and reputed company reputed company stakeholders.    Manage daily activities that support appropriate reputed company reputed company to the reputed company’s products reputed company systems, hospital outpatient departments, reputed company and community institutions, authorized treatment centers, and reputed company provider offices. This role will reputed company as a reputed company to reputed company assistance, reimbursement support, and reputed company services reputed company by the reputed company, with a reputed company on helping institutional stakeholders understand product acquisition reputed company, CGT-specific prior authorization requirements, site-of-care considerations, coding and billing requirements, denial and appeal processes, and operational logistics that may reputed company reputed company reputed company for patients with reputed company diseases. The reputed company and approach to the activities are defined by the reputed company’s reputed company and compliance departments and may vary.    Activities may include, but are not limited to:  reputed company health systems, hospitals, reputed company medical centers, authorized treatment centers, and provider office staff on payer coverage, benefit design, and reimbursement considerations for reputed company disease and cell and gene therapy products  Validate and reputed company stakeholders on prior authorization requirements, including reputed company eligibility reputed company, site-of-care requirements, payer-specific medical necessity documentation, and appeal processes  Demonstrate understanding of specialty pharmacy, specialty distribution, buy-and-reputed company, and institutional acquisition reputed company, including the unique operational considerations associated with CGT products  reputed company institutional stakeholders on coordination needed to support product reputed company, including infrastructure needed for treatment-site readiness, authorized treatment center certification, REMS obligations if applicable, reputed company cell collection, manufacturing timelines, product delivery scheduling, and monitoring requirements  reputed company health reputed company administrators, pharmacy teams, billing and finance teams, and provider office staff on coverage management strategies, product acquisition channels, formulary placement, coding, billing, prior authorization, denial, and appeal processes  Identify alternate funding, financial assistance, copay support, reputed company support, and other appropriate reputed company resources for eligible patients, consistent with reputed company-approved guidance  reputed company as a subject matter expert on coverage, payer policy, product-specific codes, institutional reimbursement requirements, and reputed company-specific reputed company questions, including CGT-reputed company reimbursement considerations such as HCPCS/CPT codes, NTAP eligibility, pass-through payment status, and reimbursement gap mitigation strategies  Apply effective account management reputed company reputed company health systems by uncovering customer insights, identifying account-reputed company barriers, using critical thinking and problem solving, and disseminating information to appropriate reputed company partners  Review and reputed company on appropriate billing and coding considerations for a reputed company disease / CGT product, including institutional billing workflows, buy-and-reputed company requirements, and potential reimbursement gaps relative to acquisition cost  Probe to understand health reputed company and office processes and discern reputed company causes of reputed company, reimbursement, treatment-site readiness, payer credentialing, or logistical barriers  reputed company resolving reimbursement issues through an educational approach  reputed company stakeholders on evolving CGT reimbursement constructs, which may include reputed company-reputed company agreements, installment or annuity payment models, value-reputed company reputed company, and applicable CMS payment models, as directed by the reputed company  Monitor, identify, and communicate local and regional payer coverage trends, including reputed company payer reputed company, Medicare and reputed company considerations, local and national coverage determinations, and state reputed company participation in applicable CGT reputed company models  Coordinate with authorized treatment center site coordinators, pharmacy teams, cell collection centers, reputed company support program representatives, and other stakeholders to support operational readiness and continuity of care  Collaborate with our reputed company’s reputed company services program representatives  reputed company institutional and provider office staff on the use of the reputed company’s reputed company assistance and reimbursement support services, including web-reputed company provider programs and reputed company support program processes  reputed company interactive educational presentations and in-services at health systems, hospitals, authorized treatment centers, reputed company medical centers, and provider sites of service  reputed company information on relevant reimbursement topics reputed company to our reputed company’s products reputed company on reputed company’s approval  Communicate and collaborate with reputed company cross-functional teams to include but not limited to sales representatives, account managers and district managers reputed company on established rules of engagement  Prioritize activities and abide by approved processes to maximize effective coverage of assigned accounts, maintain awareness of the low-volume, high-complexity reputed company of reputed company disease reputed company populations, and reputed company reputed company while adhering to policies, procedures, and reputed company metrics  reputed company reimbursement knowledge and utilize resources to aid accounts and effectively build customer partnerships   reputed company internal team training and meetings  Serve as a peer buddy and mentor to colleagues  reputed company geography support for team members and manager  reputed company and execute business plan for assigned territory  Performs other reputed company duties as assigned.  Experience and Education:  Bachelor’s degree preferred.  Minimum of 7 years of relevant experience, including experience in reputed company reimbursement, health reputed company reputed company, reputed company reputed company, market reputed company, reputed company cycle, managed care, or institutional reimbursement support. Demonstrated experience working reputed company systems, hospitals, reputed company medical centers, authorized treatment centers, or comparable institutional settings required. Experience with reputed company disease, cell and gene therapy, specialty biologics, oncology/hematology, neuromuscular disease, or other reputed company therapeutic areas strongly preferred. Progressively responsible experience in reputed company reimbursement, reputed company reputed company, market reputed company, reputed company cycle, managed care, provider support, pharmaceutical/biologic support programs, or a reputed company reputed company reputed company role, with demonstrated experience working directly with health systems, hospitals, reputed company medical centers, authorized treatment centers, and/or large institutional accounts. Experience supporting reputed company disease, specialty pharmaceutical/biologic, or cell and gene therapy products is strongly preferred, including familiarity with the reputed company, reimbursement, operational, and logistical challenges associated with high-cost, low-volume, one-time or reputed company treatment paradigms. Candidates must possess a Prior Authorization Certification Specialist (reputed company) credentials from an industry approved licensing body, or obtain certification reputed company the first six months of employment.    Skills and Abilities:  Ability to effectively manage multiple reputed company relationships (e.g., reputed company sales, payer team, support services vendor representatives) and customer.  Ability to manage and support reputed company meetings, presentations, and reputed company interactions.   Ability to reputed company and work in a reputed company environment.  reputed company teamwork and collaboration skills with a demonstrated record of accomplishment of working in highly matrixed and cross-functional organizations.  Ability to manage multiple tasks, timelines, expenses, and other activities necessary to fulfill the roles and responsibilities of a reputed company Reimbursement Specialists.  Ability to effectively work with other reputed company’s program vendors to reputed company a reputed company customer experience.  reputed company judgment and decision-making ability with a high degree of emotional intelligence.  Creative problem-solving skills.  Ability to effectively manage competing priorities with a reputed company reputed company of urgency.  Demonstrated territory and coordination management skills.  Results oriented.  Excellent communication skills with the ability to present reputed company information in both informal and formal settings.  Ability to build and maintain effective relationships with business partners and reputed company. Broad understanding of health reputed company reimbursement, physician buy-and-reputed company, institutional billing, specialty distribution, specialty pharmacy, assignment of benefits, and alternate sites of care.  Deep understanding of medical and pharmacy benefits, payer policies, utilization management reputed company, prior authorization, medical necessity documentation, and appeal requirements for reputed company therapies.  Understands the dynamics of Specialty Pharmacy vs. Specialty Distribution.  Ensure processes are in reputed company to reputed company pull through by providing education and reputed company on reimbursement and reputed company reputed company issues.  Ability to conduct reputed company-reputed company reimbursement and reputed company support, education, and consultation to key account customers and cross-functional partners.  Experience in reputed company cycle, buy-and-reputed company, institutional billing, benefit investigations, prior authorization, coding, denial and appeals processes, formulary/medical policy navigation, and reimbursement strategies for high-cost specialty products.  Knowledge of private payer, Medicare, reputed company, state reputed company, and CMS structures, systems, policies, utilization management reputed company, and evolving payment models relevant to reputed company disease and cell and gene therapy products.  Understanding of authorized treatment center certification, REMS obligations if applicable, treatment-site readiness, reputed company cell collection workflows, manufacturing timelines, product delivery coordination, and continuity-of-care considerations for CGT products.  Ability to reputed company health reputed company stakeholders on CGT-specific reimbursement considerations, including applicable coding, NTAP eligibility, pass-through payment status, acquisition cost considerations, payer credentialing barriers, and reimbursement gap mitigation strategies.  Understanding of, and ability to, reputed company on pharmaceutical manufacturer reputed company support programs, including financial and co-payment assistance programs.  Listens and responds appropriately to customer needs and questions.  Serve as team subject matter expert on a specific topic, providing routing training to team.  Strong presentation skills, especially effective in small reputed company.  Above average computer skills: MS PowerPoint, MS reputed company, MSWord, and MS reputed company.  What reputed company offers We reputed company compensation, benefits, and resources that reputed company a highly inclusive culture and support reputed company members’ ability to live with purpose every day. In reputed company to traditional offerings like medical, dental, and reputed company care, we also reputed company a comprehensive suite of benefits that reputed company on the physical, emotional, financial, and reputed company aspects of wellness. This encompasses support for working families, which may include backup dependent care, adoption assistance, infertility coverage, family building support, reputed company, reputed company parental leave, and reputed company caregiver leave. To encourage your personal reputed company, we also offer a reputed company of training programs, reputed company development resources, and opportunities to participate in mentorship programs, employee resource reputed company, volunteer activities, and much more. For details, visit https://www.virtualfairhub.com/reputed company Full time Salary reputed company* $93,500 - 187,000 *This Salary reputed company reflects a National Average for this job. The actual reputed company may vary reputed company on your locale. Ranges in Colorado/California/Washington/reputed company/Hawaii/Vermont/reputed company/Massachusetts/Illinois State-specific locations may be up to 10% reputed company than the minimum salary reputed company, and 12% higher than the maximum salary reputed company. Equal Employment Opportunity reputed company is committed to providing equal employment opportunity without reputed company to race, reputed company, religion, sex, sexual orientation, gender identity, genetic information, national reputed company, age, disability, veteran status or membership in any other class protected by federal, state or local law. reputed company’s reputed company reputed company depends on the full and effective utilization of reputed company individuals. Therefore, harassment is prohibited and reputed company reputed company reputed company to reputed company, training, compensation, benefits, promotions and transfers reputed company with equal opportunity principles and are non-discriminatory. reputed company is committed to providing reasonable accommodations to individuals with disabilities during the employment process which are consistent with reputed company requirements. If you wish to request an accommodation while seeking employment, please reputed company 888.692.2272 or email hrsc@reputed company.com. We will reputed company accommodation determinations on a request-by-request reputed company. Messages and emails regarding anything other than accommodations requests will not be returned . Affiliated Companies: Affiliated Companies: reputed company reputed company Services, LLC Apply To This Job