At Blue Earth Diagnostics, our mission is to transform the clinical management of patients with cancer by developing innovative molecular imaging technologies. Our team is made up of industry leaders in the field of radiopharmaceutical development and commercialization. Blue Earth Diagnostics is a dynamic and growing company with an approved product already on the market in the USA and in Europe. Blue Earth Diagnostics is a subsidiary of Bracco Imaging S.p.A., a global leader in diagnostic imaging.
Reporting to the Senior Director, Patient Access & Healthcare Policy, the Field Reimbursement Specialist position is a critical role to ensure reimbursement of a novel diagnostic radiopharmaceutical that was approved by the FDA in May 2016. The scope of the role includes working directly with customers, both imaging sites and referring physician offices, to serve as an expert in payer policies and provide support to facilitate appropriate patient access.
The incumbent will be ready to bring his or her previous customer experience and relationships into a setting that has a strong existing reimbursement foundation with Medicare coverage, a product-specific code and transitional pass-through payment in the Medicare hospital setting. The Field Reimbursement Specialist will enable customers to successfully gain prior authorization approvals and coverage for appropriate patient scans, in addition to providing hands-on education, and supporting the field sales teams.
Key success factors for this role include experience and competence in relationship building, concise presentation of complex healthcare policy and reimbursement information, and the ability to quickly identify solutions to address both customer and business needs.
Candidates will be comfortable working in a small company environment and will have led high performance organizations in accomplishing stretch objectives in a quick-paced, patient focused culture
Essential Duties and Responsibilities:
- Provide expert guidance to imaging sites to ensure accurate claims submission, best practices sharing for prior authorization and appeals, scheduling tips, understanding of reimbursement landscape, liaise providers with payers where appropriate.
- Educate and support referring physician offices with best practice sharing for prior authorizations and appeals, coverage landscape of Axumin, etc.
- Develop and maintain relationships with identified key customers.
- Providing Payer Relations Managers with field updates on specific payer challenges; connect potential payer KOLs; and communicate day-to-day learnings that may assist the payer team in their activities.
- Perform quarterly reviews with assigned customers to provide ongoing support and uncover payer issues; escalate payer issues to Payer Relations Manager.
- Coordinate with reimbursement support line consultants, where appropriate, to provide updates, guidance, and address challenges with reimbursement as reported by users.
- Provide regular status reports and tracking of customer education/interaction and results.
- Work collaboratively with other functional areas to ensure regional customer reimbursement support.
- Other projects as determined through discussion and planning with Director of Patient Access & Healthcare Policy.
To perform the job successfully the individual should demonstrate the following competencies:
- Interpersonal Skills & Ethics – A natural focus on “team”, with a resourceful and collaborative approach to working. Treats people with respect; inspires and earns the trust of others; conducts all activities with integrity while observing all relevant laws, regulations, ethical standards and conventions.
- Oral and Written Communication – Actively listens and responds effectively to questions; leads effective meetings; able to effectively prepare and then communicate options and recommendations pertaining to reports, reporting improvements, and overall CRM-system considerations for the betterment of the team.
- Cost Consciousness & Organizational Support – Works within approved budget; conserves organizational resources and offers suggestions on how to accomplish individual and business goals more efficiently and effectively at lower costs. Observes policies and procedures; completes administrative tasks consistent with company policies and on time; supports organizational goals and values; contributes to evolving culture.
- Planning/Organizing & Dependability – Is highly organized; prioritizes and plans work activities; uses time efficiently; sets goals and objectives with realistic action plans; proactively checks self against objectives and modifies as needed.
- Initiative & Innovation- Undertakes self-development activities; seeks increased responsibilities; looks for and takes advantage of opportunities; asks for and offers help when needed. Displays original thinking and creativity; meets challenges with resourcefulness; generates suggestions for improving work.
- Bachelor’s degree preferred with 3-5 years working in reimbursement, managed care sales / marketing or related field. In place of a bachelor’s degree, 10+ years of relevant experience will be accepted.
- 5+ years demonstrated experience and success in healthcare industry, preferably imaging, diagnostics, or pharma
- Ability to work directly with hospitals/imaging centers on payer specific issues
- Knowledge of medical benefit plan design (Commercial, Medicare, Managed Care)
- Ability to lead/facilitate live training and education
- Highly developed time management skills with demonstrated ability to meet deadlines and handle multiple priorities with a high degree of initiative required
- Well-developed analytical, problem solving, and influencing skills, appropriately balanced with strong interpersonal and teaming skills
- Excellent communication (written, verbal, and presentation) skills with ability to interact with all levels of management for both internal and external customer base
- Demonstrated ability to successfully manage high impact relationships and projects
- Strong advising, facilitation, and organizational skills; team player. Experience and skills with cross-functional and highly matrixed organizations
- Ability to work effectively and independently from a home office, but must be able to travel as needed (up to 70% of the time)
- Basic knowledge of compliance aspects relative to industry and reimbursement policy
- Qualified candidate must be legally authorized to be employed in the United States
HOW TO APPLY:
To apply, please submit your CV and a covering letter with the title of this job in the subject line to email@example.com outlining:
- Why this role appeals to you
- How your background and skills are suited to this role
Blue Earth Diagnostics offers competitive compensation for high-caliber candidates.
Blue Earth Diagnostics, Inc. provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, ethnic/national origin, military and/or Veteran status, age, disability, genetics, marital status, sexual orientation or medical condition in accordance with applicable federal, state and local laws.