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Oncology Access Solutions Manager
2 months ago
Reports To: Director, Access Solutions Managers
Location: Field-based in the Western United States
Classification: Exempt
Position Overview:
The Oncology Access Solutions Manager (OASM) plays a crucial role in reducing access and reimbursement obstacles for patients and healthcare providers, thereby enhancing the availability of Coherus' Oncology product range. The OASM is tasked with identifying and addressing access challenges within their designated territory by collaborating strategically with clients and healthcare facilities to resolve intricate patient access dilemmas throughout the reimbursement process. The OASM actively educates and supports practices, facilities, and their personnel regarding Coherus reimbursement assistance programs (Coherus SolutionsTM).
As an integral member of the field team, the OASM serves as the primary contact for reimbursement and access-related inquiries. They will facilitate the education and implementation of account strategies for Coherus products within relevant healthcare settings. Additionally, the OASM will assess reimbursement and access challenges and act as the local resource for internal Coherus stakeholders within their assigned area. The OASM will work collaboratively across Corporate Accounts, Patient Services, and Field Sales to ensure patient access to medications.
Key Responsibilities:
- Engage with internal and external partners to identify, foresee, and resolve patient and practice reimbursement challenges.
- Work alongside Field Sales to pinpoint facilities and practices requiring reimbursement education and support concerning Coherus products.
- Provide updates and insights regarding the integration of products and support services at client accounts.
- Educate facility personnel on protocols related to product procurement, inventory management, and payer policies to ensure seamless integration of products into practice workflows.
- Deliver coverage, coding, and reimbursement information to key stakeholders (e.g., practice administrators, reimbursement staff, and providers) to effectively support patient access.
- Collaborate with the field-facing team to share insights into customer needs, potential barriers, and payer issues/opportunities for access at practices.
- Communicate and clarify payer policy updates or system modifications that affect access.
- Proactively inform office staff about Coherus COMPLETETM to ensure familiarity with patient access programs and services.
- Address inquiries related to patient coverage, access, and reimbursement from accounts in conjunction with patient services as per established policies and procedures.
- Conduct regular claim assessments with practices to guarantee appropriate reimbursement for Coherus products.
- Maintain a comprehensive understanding of Coherus policies and requirements, executing the role in a compliant manner aligned with company guidelines.
- Stay informed about customer and market access industry trends.
- 5+ years of experience in the pharmaceutical or biotechnology sector.
- 3+ years of experience in healthcare coverage, coding, and/or reimbursement.
- Direct experience with Buy and Bill products, Medicare Part B, and Miscellaneous J-Codes is essential.
- Oncology experience is highly preferred.
- Bachelor's degree from an accredited four-year institution.
- Prior experience collaborating with billing and medical claims personnel across various healthcare environments, including physician offices, hospitals, HOPD, and ASCs.
- Demonstrated expertise in assisting healthcare provider offices with coding, billing, and submissions across diverse payer landscapes.
- Proficient in implementing and executing Medicare, Medicaid, and other payer initiatives.
- Familiarity with CPT, HCPCS, and ICD-10 revenue codes.
- Knowledge of health insurance claim forms, explanations of benefits, prior authorization forms, and EMR/Practice Management systems to troubleshoot billing, claims submission, or documentation issues.
- Ability to analyze, interpret, and comprehend regulatory and legislative payer and healthcare policies.
- Candidates must reside within the assigned territory and be willing to travel up to 70% of the time.
The Base Salary Range for this position is $165,000 to $190,000. Coherus considers various factors, including professional background and work experience, when determining base pay. These considerations mean actual compensation will vary.
Coherus BioSciences is committed to providing equal employment opportunities to all employees and applicants for employment and prohibits unlawful discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws. We also prohibit discrimination based on the perception that anyone has any of these characteristics or is associated with a person who has or is perceived as having any of these characteristics.
