This position requires medical and/or pharmacy billing experience. Only candidates with this experience will be considered for interviews. Please do not submit your resume if you do not have this experience.
Summary: The Reimbursement and Payer Marketing Manager reports to the Sr. Vice President Payer Relations of the Alliance. The position is responsible for the reimbursement and payer marketing activities of the Hemophilia Alliance and Hemophilia Alliance Network Services. The reimbursement and payer marketing activities include but are not limited to:
- Lead billing and reimbursement efforts for organizations that have purchased our billing and reimbursement services
- Manage HANS payer contracts and work with payer and participating members on reimbursement procedures and any reimbursement issues
- Support and assist HTCs on billing and reimbursement issues with payers
- Develop and manage database of payer issues and complete trend analysis
- Develop payer contact database using current contacts (HA Team Members) and Policy Reporter Payer Contacts
- Send monthly email campaigns to payers with HANS updates and arrange meetings, webinars, conference calls
- Manage HANS marketing material – develop new and keep existing current
- Manage HANS payer PowerPoint template and keep updated
- Manage HANS website/webpage and keep updated
- Attend payer conferences
- Payer dashboard – trend analysis on payers and competition
- Aggregate payer data for reporting and submission to payers
- HTC member data:
- Develop and implement member database for tracking payer activity
- Payer issues so data can be aggregated regionally and nationally
- Manufacturer trend analysis of purchase/sales data:
- By product
- By manufacturer
- Other analysis as needed
- Complete reporting to manufacturers
Travel: Approximately 15% of time traveling to payers, conferences, and member HTCs is expected. Must possess a valid driver’s license and be able to travel nationally.
- Knowledge of hemophilia reimbursement and payer marketing that has been gained by working in the hemophilia market or similar specialty market and knowledge of managed care and insurer contracting, normally obtained through completion of a Bachelor’s Degree in Business Administration, and two to five years of healthcare and/or insurance reimbursement and/or payer marketing experience.
- Must be able to set, organize own work priorities, and adapt to frequent change.
- Must possess proven reimbursement knowledge and skills.
- Must possess strong analytical and financial skills.
- Must possess strong written and verbal communication skills.
- Must possess a personal presence that is characterized by a sense of honesty, integrity, and caring with the ability to promote the philosophy, vision, mission, goals, and values of The Hemophilia Alliance.
- Must have knowledge of Office 365 suite of products.
- Bachelor’s Degree in Business Administration or related field.