- Eisai, Inc (Dayton, OH)
- …until appropriate resolution. This role will have a keen understanding of payer coverage at the customer and regional level and strong communication skills ... to appropriately educate on payer policies. This role will support the Neurology business unit, providing compliant access and reimbursement education to support an… more
- Knox Community Hospital (Mount Vernon, OH)
- …documentation with pre-certification/authorization initially and as directed by insurance payer and Case Management leadership. Adheres to organizational policies ... terminology, ICD10 and CPT coding skills required. Knowledge of third party payer processes preferred and compliance regulations processes Knowledge of Medicare and… more
- Eisai, Inc (Nutley, NJ)
- …portfolio into the appropriate segments and channels across the defined Corporate Payer Accounts. The incumbent will be expected to create the appropriate segment ... be necessary. This position will be a member of the Market Access Payer team and will work collaboratively with appropriate Eisai stakeholders regarding access and… more
- Merck & Co. (North Wales, PA)
- …by collaborating with directors and brand managers within Marketing and Payer Marketing and ensuring integration with other Integrated Account Management customer ... that leverage pharmacy as a channel to consumers, support pharmacy as a payer , and support pharmacists as healthcare professionals in need of disease and product… more
- Eisai, Inc (Chicago, IL)
- …the field in projects that will optimize brand performance in the various payer channels. These projects may be brand specific, payer -specific or ... with health care in any specific segment (eg, trade, payer ).Strong account management and cross-functional leadership experience.Experience owning and negotiating… more
- Merck & Co. (Rahway, NJ)
- …to ensure that clinical, commercial and access strategies fully reflect payer /HTA requirements.Represents the perspectives and experiences of their team to shape ... evidence generation that has supported optimal recommendations/guidelines, reimbursement, and payer /provider access and treatment decisions. Preferred Experience and Skills:… more
- Lundbeck (Fort Wayne, IN)
- …and collaboration based on customer needs and organizational goals. Payer Access -Ability to grasp sophisticated reimbursement and distribution processes ... portfolio to key internal and external partners and effectively addresses payer access issues (Medicare, Medicaid, Commercial) using Lundbeck resources. Local Market… more
- Merck & Co. (Rahway, NJ)
- …IIS with therapeutically assigned areasCoordinates with Outcomes Research through the USMA Payer Access Teams (PATs) to ensure team support of therapeutic aligned ... real-world evidence-Coordinates strategy, planning, and execution of scientific congress responsibilities comply with all company policies and applicable laws, regulations, and ethical standardEducation:Doctoral Degree (MD, PharmD, PhD) with demonstrated… more
- Eisai, Inc (Nutley, NJ)
- …Research/Health Economics either within biopharmaceutical industry and/or provider/ payer organizations.Demonstrated applied research experience in conducting health ... economic, health related quality of life, and/or health services research studies. Experience in analyzing and collecting patient-reported outcomes, claims and EMR databases. Demonstrated ability to work collaboratively in and lead cross-functional… more
- Eisai, Inc (Atlanta, GA)
- …and quality trends (340B, buy & bill, Government, and commercial payer coverage) preferred.Understanding of the market access and reimbursement landscape ... preferred.Substantial experience working with key laws and regulations impacting the pharmaceutical industry (eg, PhRMA Code; Federal Food, Drug, Cosmetic Act; Anti-Kickback Statute; False Claims Act, OIG/DOJ Guidance; Foreign Corrupt Practices Act; and… more
- Lundbeck (Atlanta, GA)
- …to stay informed on reimbursement dynamics, anticipate and effectively address payer access issues (IDNs, Medicare, Medicaid, Commercial) using Lundbeck resources. ... Pharmaceutical Environment/Compliance - Apply knowledge of pharmaceutical and regulatory environment, including accountability and adherence to Lundbeck policies and procedures and FDA regulations regarding the promotion of pharmaceutical and medical products.… more
- Soliant (Fort Lauderdale, FL)
- …Maintain compliance with ACHC specialty accreditation, state/federal regulations, and payer requirements Drive operational efficiency, workflow optimization, and KPI ... achievement Lead business development efforts including provider outreach, partnerships, and community engagement Oversee inventory management, budget adherence, and financial performance Ensure quality management programs and regulatory readiness across the… more
- Lundbeck (Miami, FL)
- …to stay informed on reimbursement dynamics, anticipate and effectively address payer access issues (IDNs, Medicare, Medicaid, Commercial) using Lundbeck resources. ... Pharmaceutical Environment/Compliance - Ability to apply knowledge of pharmaceutical and regulatory environment, including accountability and adherence to Lundbeck policies and procedures and FDA regulations regarding the promotion of pharmaceutical and… more
- Daiichi Sankyo, Inc. (Tacoma, WA)
- …access environment (including but not limited to pharmacy economics, payer reimbursement landscape, and patient flow/influence between academic institutions, ... hospitals, and community practices).Demonstrate understanding of current or pending clinical pathways in assigned accounts, and how they influence patient treatment.Analyze customer needs and interests, territory performance, program outcomes, and business… more
- Lundbeck (San Diego, CA)
- …position Lundbeck's products within the context of the provider's setting and payer mix. Managing Execution Sets and maintains competent product knowledge and ... selling skills standards within the team. Directs and monitors the execution of approved marketing plans and promotion campaigns. Evaluate and identify improvement and development opportunities of account managers through performance management process to… more
- PharmaCord (Jeffersonville, IN)
- …and analyze information and resources related to local, regional or national payer coverage or claim submission process Clearly articulate complex reimbursement and ... and financial responsibility Educate provider offices on local and regional payer coverage policies, issues, coding changes, and appropriate claims submission… more
- Agendia, Inc (Irvine, CA)
- …policies of payors and work them in priority dependent on allotted timeframes per payer as the time can vary. *Contacts ordering physician's office to obtain missing ... *Previous medical billing experience preferred *Ability to read and understand medical payer policies as well as pathology reports *Ability to work with sensitive… more
- Accessia Health (Midlothian, VA)
- …benefit managers to identify and verify patient insurance coverage Identify payer coverage restrictions while maintaining high quality customer service standards in ... compliance with federal and state regulations Maintain a repository of payer coverage information or case studies Proactively update patient-related information to… more
- Reveal Health Tech (New York, NY)
- …documentation, and solution validation. Solid understanding of healthcare operations, payer /provider systems, and terminology. Proficiency in data analysis and ... (EHR) systems Medical coding standards such as FHIR, ICD, CPT Medicare/Medicaid data ( payer and/or provider side) UX Design principles and tools like Figma Web… more
- PharmaCord (Jeffersonville, IN)
- …in obtaining coverage Leverages electronic tools to identify benefits and payer coverage; completes manual benefit investigation as needed Identifies and ... communicates patient's plan benefit coverage including the need for prior authorization, appeal, tier exception, and/or formulary exclusions Uses electronic resources to obtain benefit coverage outcome and if needed, outbound call to payers and HCPs to follow… more
