CLINICAL OUTCOMES MANAGER jobs in Euclid, OH

Description

You are an expert facilitator: you open doors, foster communication, and bridge the gap.

The Field Reimbursement Manager will be responsible for the management of defined accounts in Urology and Oncology area, specifically supporting our client’s product. The Field Reimbursement Manager will execute the collaborative territory strategic plan through partnership with internal and external stakeholders, including acting as an extension of patient support program and in other collaboration with other partners. Responsibilities include ensuring understanding and communicating Reimbursement, access, and program support program as it relates to the product. The Reimbursement Manager will also work on patient level reimbursement issue resolution, and thus will need access to be knowledge of and have had experience with patient health information (PHI), navigating access issues, and working with payer and NCCN guidelines for product utilization.

Field Reimbursement Managers manage daily activities that support appropriate patient Reimbursement to our client's products in the provider offices and work as a liaison to other patient support programs offered by our client. Activities may include, but are not limited to:

• Provide in-person or virtual one-on-one support to address questions about coding, coverage, reimbursement, and patient support requirements
• Support patient access assistance from prescriber decision through to fulfillment, supporting the entire Reimbursement journey through payer prior authorization to appeals/denials requirements procedures and forms
• Reviewing patient-specific information in cases where the site has specifically requested the assistance and patient health information is available in resolving any issues or coverage challenges
• Reviewing patient insurance benefit options, in cases where patient health information is available as a result of patient hub enrollment
• Coordinating with other patient support service program representatives and with commercial field team members, as needed
• Collaborating across commercial matrix to share access insights
• Educating physician office staff on the use of the patient assistance programs and patient support services, including web based provider programs
• Provide information on relevant Reimbursement topics related to the client product
• Serve as payer expert for defined geography and able to communicate changes to key stakeholders in a timely manner
• Deliver educational in-services and building territory planning

Along with demonstrated initiative, resourcefulness and a results-oriented mindset, the ideal candidate has:

• Bachelor’s Degree required
• 5 years field experience
• Minimum 2 years covering reimbursement
• Oncology Experience required
• Specialty pharmacy and buy and bill and hub partnership experience required
• Knowledge of CMS policies, commercial insurers, managed care, government and federal payer sectors, IDNs, and IHS required
• Comfortable working and communicating NCCN guidance including covering category 2B off-label recommendations for determination of Medicare reimbursement eligibility
• In-depth knowledge of coverage and access for pharmacy-benefit & medical-benefit products, including private payer, Medicare, & Medicaid
• Excellent customer service & remote engagement skills
• Demonstrated level of proficiency with support technology (e.g., PC, tablet, & Customer Relationship Management (CRM) tools)
• Conduct business in compliance with all industry & customer guidelines.
• Specific knowledge and experience with access, billing & coding of drugs, and/or biologics. Must have general payer policy knowledge including public & private payers, foundational knowledge of benefit verifications & prior authorization/pre-determination requirements (including appeals/exceptions), & knowledge of access & reimbursement processes within various sites of care

At Syneos Health, we are dedicated to building a diverse, inclusive and authentic workplace. If your past experience doesn’t align perfectly, we encourage you to apply anyway. At times, we will consider transferable skills from previous roles. We also encourage you to join our Talent Network to stay connected to additional career opportunities.

Why Syneos Health? Our ability to collaborate and problem-solve makes a difference in patients' lives daily. By joining one of our field access teams, you will partner with industry experts and be empowered to succeed with the support, resources, and autonomy needed to successfully navigate the complex reimbursement landscape. The diversification and breadth of our new and existing partnerships create a multitude of career paths and employment opportunities. Join our game-changing, global company dedicated to creating better, smarter, faster ways to get biopharmaceutical therapies to patients Experience the thrill of knowing that your everyday efforts are contributing to improving patients' lives around the world.

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Syneos Health companies are affirmative action/equal opportunity employers (Minorities/Females/Veterans/Disabled)

Syneos Health has a voluntary COVID-19 vaccination policy. We strongly encourage all employees to be fully vaccinated. Additionally, certain local governments or Syneos Health customers may have vaccine requirements that apply to some of our employees. These employees are required to submit proof of vaccination to Syneos Health and maintain compliance with these requirements.
At Syneos Health, we believe in providing an environment and culture in which Our People can thrive, develop and advance. We reward and recognize our people by providing valuable benefits and a quality-of-life balance. The benefits for this position will include a competitive compensation package, Health benefits to include Medical, Dental and Vision, Company match 401k, flexible paid time off (PTO) and sick time. Because certain states and municipalities have regulated paid sick time requirements, eligibility for paid sick time may vary depending on where you work. Syneos Health complies with all applicable federal, state, and municipal paid sick time requirements.