BeiGene
Location
San Mateo, CA | United States
Job description
General Description:
The Northeast Division Field Reimbursement Director (FRD) helps minimize access & reimbursement barriers for patients and providers to optimize access. Within their geography, the FRD is responsible for addressing access barriers by strategically working with customers and accounts to solve the most complex patient access issues through all facets of the reimbursement cycle. The FRD proactively provides education and support on myBeiGene Patient Support Program to practices, facilities, and their staff. They serve as the key contact responsible for reimbursement and access support-related matter. The FRD will provide education and support the integration of account implementation plans for Beigene products within practices and sites of care where applicable. Additionally, the FRD will analyze reimbursement and access issues and act as the local access and reimbursement resource for internal BeiGene partners in their assigned geography. The FRD will coordinate cross functionally across Corporate Accounts, Patient Services and Field Sales to support patient drug accessibility.
Responsibilities
Collaborate with Field Sales to identify facilities and practices that need reimbursement education and support.
Partner with internal and external stakeholders to identify, anticipate and address patient and practice reimbursement issues.
Provide insights and updates regarding product and support service integration at accounts.
Educate facility staff on distribution model and all payer polices related to support full integration of product into the practice workflow.
Provide coverage, coding, and reimbursement information to key staff members (i.e., practice administrators, reimbursement staff, and providers) in order to appropriately support patient access.
Collaborate with field facing teams to compliantly share insights into customer needs, potential barriers, and payer issues/opportunities for access at practices.
Communicate and explain payer policy updates or system changes that impact access.
Proactively communicate myBeiGene Patient Support Program so that office staff is fluent in how to use patient access programs and services.
Address questions associated with patient coverage, access, and reimbursement from accounts in collaboration and coordination with patient services as directed by policy and procedure.
Conduct frequent claim reviews with practices to ensure appropriate reimbursement.
Maintain a deep understanding of Beigene policies and perform the role in a compliant manner consistent with company guidance.
Keep abreast of customer and market access industry trends.
Execute on the account implementation plan within practices and sites of care where applicable.
Work cross functionally to analyze reimbursement/access issues, and act as the local access and reimbursement resource for internal partners.
The Director of Field Reimbursement will work closely with Field Sales, Corporate Account Directors and Payor to support patient drug accessibility.
Partner with internal and external stakeholders to identify, anticipate and address patient and practice reimbursement issues.
Track and analyze reimbursement data to identify areas of improvement and make appropriate recommendations.
Proactively support Department leadership on projects as needed; Communicate effectively within department and cross functionally.
Education Required:
Required Experience:
BA/BS with 10 years of overall experience or MA/MS with 7 years of overall experience.
5 plus years of related pharmaceutical experience.
2 plus years of direct experience in Oncology Field Reimbursement.
Direct experience with Buy and Bill products, Medicare Part B and Miscellaneous J-Codes required.
Bachelor's degree from a four-year college or university.
Previous experience working with billing and medical claims personnel in various health care settings, including physician office, in patient/outpatient hospital, and Home health.
Shown expertise in supporting healthcare provider offices with coding, billing, and submissions in range of payer environments.
Well versed with implementing and executing Medicare, Medicaid, and other payer initiatives
Familiar with CPT, HCPCS, ICD-10 revenue codes.
Familiarity with health insurance claim forms, explanation of benefits, prior authorization forms, and EMR/Practice Mgmt. systems, to troubleshoot cases where billing, claims submission or documentation errors may occur.
Ability to analyze, interpret and understand regulatory and legislative payer and healthcare policies
Candidate must reside within assigned territory and have the ability to travel up to 50-60%
Preferred Qualifications:
Possess leadership skills with a demonstrated ability to influence different styles.
Able to identify and implement recommendations for improving processes and efficiency.
Proven ability to collaborate and build relationships across all key internal & external stakeholders, including executive management.
Positive attitude to embrace occasional special projects as part of collaborative team or individual contributor.
Product launch experience, including J-code application process.
Computer Skills :
Travel:
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.
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