Manager Cvs Prior Authorization Jobs in Virginia

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If you're hungry to build a varied and meaningful career in a community of brilliant and diverse minds to make a real difference, there's only one choice. Associate Director - Field Reimbursement Manager, Oncology - Mid-Atlantic Associate Director - Field Reimbursement Manager, Oncology - Mid-Atlantic Responsible for ensuring patient access to Bayer oncology products within assigned geographical area via supporting HCPs and Office staff in navigating therapy Prior Authorizations (PAs), Medical Necessity documentation and therapy PA denial appeals. Develop collaborative working partnerships with HCPs and Office Staff, to support Patient access to therapies.

This position works with medical practice therapy decision makers, practice clinical administrators, key office support staff and clinical pharmacists to assist with Health Plan/PBM therapy approval requests. This position is also responsible for collaboration with the Bayer Patient Support Services Team, Market Access Field Teams, Bayer AGMs, SCs and MSLs to execute reimbursement and access programs to reduce access and affordability hurdles for patients on Bayer oncology products. The span of coverage will be Mid-Atlantic which covers North Carolina, South Carolina, Washington DC & Virginia.

Travel up to 50% within the territory. The candidate must be domiciled within the territory. KEY TASKS AND RESPONSIBILITIES Extensive disease state/therapy space experience (specific to Bayer Programs/Therapies); Govt, National and local Commercial Payer experience, State Medicaid, and Managed Plans; Experience in educating and supporting Prior Authorization process, appeals, and denials; Covermymeds - portal access experience a plus; Proactive education - Access Services by Bayer; Stay current with local MAC policies and procedures; Excellent verbal and written communication skills as well as prior experience educating providers; Collaborating across multiple stakeholders; Proactive Problem solving, defusing, and resolving escalations, consistent and timely follow up; Proven experience in flexibility and adaptability Territory Management; Ability to engage and navigate HCPs in various settings including hospitals, private practice, large multi-specialty practices, IDNs, IDN out-patient clinics and other facilities; Initiative-taking business acumen to identify and resolve HCP/Office Staff issues/challenges with Payer/PBM therapy approvals; New Product / Indications launch experience; Must have a valid driver's license with a safe driving record/ MVR; Specialty Pharmacy Experience; Experience educating and/or supporting pharmacies.

WHO YOU ARE Bayer is seeking an incumbent who processes the following: REQUIRED QUALIFICATIONS Bachelor's Degree or minimum of 5 years' healthcare related reimbursement experience; 2 + years Field Reimbursement experience; In depth understanding of Payer/PBM therapy approval requirements (Prior Authorization, Medical Necessity, Denial Appeals, Formulary coverage and payment for oncology therapies across all sites of care (hospital, clinic, integrated delivery network) and ability to apply this knowledge to address individual customer concerns; Broad knowledge of Medicare, managed care, third party payers and Medicaid; Demonstrated excellence in meeting and exceeding customer expectations especially in demanding situations; Ability to effectively address customer concerns in a timely fashion and by working collaboratively with external and internal stakeholders; An elevated level of sophistication/people skills needed to interact with practice clinical decision makers, office support staff, clinical pharmacists, and office managers; Must demonstrate a comprehensive knowledge of customer relations, therapy formulary coverage, utilization management, and able to interpret complex information; Must possess the leadership ability to effectively organize, communicate and collaborate with HCPs, Key Practice Staff and Bayer external and internal team members; Exceptional knowledge of Healthcare Management; Pharmaceutical Manufacturer federal, state, and local compliance requirements; Area Reimbursement Managers will cover multiple regions, thus significant overnight travel, up to 50%; Must have a valid driver's license with a safe driving record/ MVR. PREFERRED QUALIFICATIONS 2 + years Oncology Field Reimbursement Experience; Experience in oncology and working with key oncology stakeholders. Employees can expect to be paid a salary between $162,000.00 - $243,000.00 Additional compensation may include a bonus or commission (if relevant)

Additional benefits include health care, vision, dental, retirement, PTO, sick leave, etc. This salary range is merely an estimate and may vary based on an applicant's location, market data/ranges, an applicant's skills and prior relevant experience, certain degrees and certifications, and other relevant factors. This posting will be available for application until at least 08/20/2026.

#LI #LI-AMS YOUR APPLICATION Bayer offers a wide variety of competitive compensation and benefits programs. If you meet the requirements of this unique opportunity, and want to impact our mission Health for all, Hunger for none, we encourage you to apply now. Be part of something bigger.

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