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Oncology Field Reimbursement Consultant

Oncology Field Reimbursement Consultant
District of Columbia, Maryland, North Carolina, Virginia
United States
North America
At Lilly, we unite caring with discovery to make life better for people around the world. We are a global healthcare leader headquartered in Indianapolis, Indiana. Our 39,000 employees around the world work to discover and bring life-changing medicines to those who need them, improve the understanding and management of disease, and give back to our communities through philanthropy and volunteerism. We give our best effort to our work, and we put people first. We’re looking for people who are determined to make life better for people around the world.
As part of the Managed Healthcare Services within Lilly USA, LLC, the Field Reimbursement Manager (FRM) is a field-based non-promotional role within Lilly Patient Services reporting directly to a US Regional Field Director. The FRM is seen as an elite member of the Oncology Field Reimbursement Team based on their leadership skills and business impact with peers and customers. The FRMs are subject matter experts in educating and problem solving patient access and reimbursement issues and help Healthcare Providers offices understand how Lilly Customer Support Programs (CSP) can assist patients. The FRM will proactively work with assigned HCP accounts and integrated delivery networks to build and maintain relationships with office support staff. The FRM must work seamlessly and in coordination with all Lilly customer support services, specialty pharmacies, and other field teams while supporting patient access. The FRM will manage daily activities to support patient access to Lilly products in healthcare provider’s offices including:
  • Demonstrate deep knowledge in reimbursement and access across many Customer Support Programs and the subject matter expert in their region of the country
  • Links with sales representatives, the specialty pharmacy (SP) advisory team, customer support programs, and national/regional account managers to escalate and resolve local payer issues
  • Demonstrates strong problem solving skills related to complex patient access challenges across payers and specialty pharmacies
  • Design, modify and execute peer leadership and mentoring roles
  • Able to condense complex issues into simple solutions ideas by working with peers and internal stakeholder to improve the customer experience
  • Educate office staff about financial assistance and alternative funding options for the uninsured and underinsured
  • Educate providers on reimbursement requirements, coverage status, and payer appeals requirements, processes and timelines
  • Knowledge of all phases of specialty pharmacy core services and connectivity to assist with the complexity of patient access
  • Interact directly with specialty pharmacies to assure a positive customer experience
  • Review benefits investigation results with office staff upon request once patient authorization has been obtained
  • Member of internal advisory teams to provide customer insights that will lead to customer solutions
  • Knowledge of healthcare structures, payment systems, and reimbursement methodology
  • Bachelor’s Degree required
  • Valid driver’s license and acceptable driving record
  • Minimum three years of relevant work experience in the following areas:
    • Patient Navigation
    • Payer
    • Reimbursement
    • Medical billing and coding
    • Specialty Pharmacy
    • Oncology and/or Specialty Biotech Product Sales
  • Qualified candidates must be legally authorized to be employed in the United States. Lilly does not anticipate providing sponsorship for employment visa status (e.g., H-1B or TN status) for this employment position
  • Demonstrated ability to conduct field-based customer support and consultation related to payer coverage and payment processes
  • Demonstrated experience with "buy-and-bill" process
  • Territory management skills/experience
  • Experience working with provider offices such as a physician practice, patient assistance programs, or similar pharmaceutical support program preferred
  • Understand HIPAA rules and regulations related to patient privacy
  • Excellent computer skills, including knowledge of Microsoft Office products including Outlook, Excel, Word, and Power Point
  • Strong written and verbal communications as well as presentation skills
  • Ability to manage expenses within allocated budgets
Lilly is an EEO/Affirmative Action Employer and does not discriminate on the basis of age, race, color, religion, gender, sexual orientation, gender identity, gender expression, national origin, protected veteran status, disability or any other legally protected status.

Territory Specifics:
  • The Richmond, VA FRM position will require roughly 40% travel
  • Territory includes: NC, VA, WV, DC, MD, and a small area of DE
Field Based – Can live in Virginia, DC, Maryland or Raleigh, NC