Oncology Medicare Account Executive Southeast Territory

Merck & Co., Inc. Atlanta , GA 30301

Posted 7 days ago

Job Description:

Our Oncology team is dedicated to delivering breakthrough innovations that extend and improve the lives of cancer patients worldwide. Our team of forward-thinking individuals achieve this through an unwavering commitment to support accessibility to medicine, providing new therapeutic solutions, and collaborating with governments and payers to ensure that people who need medicines have access to them. Our focus is on innovation and launch execution excellence; we translate breakthrough science into innovative medicines that help people with cancer across the globe.

Job Description:
Oncology Medicare Account Executive

Account Manager responsible for obtaining MAC access to Part B infused drugs in Oncology and other areas. therapeutic areas through work with MAC personnel, CAC members and Oncology State Societies.

  • Responsible for managing relationship with 11 Oncology State societies, CAC members, and 3 MAC jurisdictions covering 9 states in the southeast US and approximately 25% of FFS Medicare.

  • Responsible for gaining and ensuring FFS Medicare access for all Food and Drug Administration

  • approved indications for brand named products and other infused part B medicines.

  • Monitor and manage policies, processes within MAC jurisdictions that impact access such as LCDs, Edits, Markup Elimination's, Testing, coding articles, etc.

  • Develop Reimbursement Key Opinion Leader 's who can provide support when access issues arise.

  • Educate and support sales and surround sound teams regarding policy and coverage issues.

  • Monitor claims database to ensure prompt payment and identify any potential payer/reimbursement issues.


  • 10-15 years pharmaceutical experience, at least 5 years of large account management, minimum 5 years buy and bill reimbursement experience (not rep experience with a buy and bill drug but actual reimbursement experience).

  • Minimum 2 years of experience shaping/influencing medical policy of MACs and/or regional payers for buy and bill drugs, addressing payer policy issues.

  • Strong clinical expertise particularly in area of immuno-oncology.

  • Understanding of impact of medical policy on access and reimbursement processes.

  • Superb presentation skills with experience presenting to boards of directors and medical directors.

  • Experience collaborating with oncology state societies and managing projects.

  • Track record of achieving positive coverage and access for buy and bill medications through successful management of payer and reimbursement KOL relationships.

  • Ability to successfully work in cross functional teams and to collaborate with large number (150) of team members.

  • Ability to identify and develop reimbursement KOLs in 9 state geography.

  • Strong understanding of regulatory environment and compliance policies.

  • Strong clinical oncology knowledge and ability to communicate clinical information on over 20 indications to medical directors

Necessary Skills:

  • Existing relationships with MAC personnel, CAC members and state society executive directors

  • Understanding of policy impact on reimbursement processes and protocols

  • Excellent Group and Individual Presentation Skills

  • Effective Collaborator and Team player

  • Working and Leading Cross-Functional Teams

  • Ability to navigate through complex situations involving various stakeholders

  • Judgement/Compliance/Regulatory understanding

  • Strong I/O Clinical Oncology knowledge

  • Understanding of testing, MolDx policies

  • Executive Presence

  • Launch experience especially with buy and bill drug with miscellaneous code

  • Data analysis

  • Advocate development

  • Project management

  • Ability to change behavior

  • Networking

  • Organizational Skills

  • Deep understanding of buy and bill, HCPCS codes, International Classification of Diseases

  • 10 codes, CPT codes, medical policy, revenue cycle, ASP, MUEs, Claim Submission, CMS and MAC processes, Medicare Part A, B, C and D. OCM, NOC drugs, edits, LCD process,
  • Excellent skills with Office 365 and programs such as PowerPoint, Word, Excel, OneNote, etc

  • Travel: 50-75%, frequent weekends in spring and fall.

Position Location: Upper Gwynedd, PA or Home Office based anywhere in geographical region.

Geography includes FL, GA, AL, TN, SC, NC, VA and WV. Specific geography subject to change.


  • Required: BA/BS
  • Preferred: MBA

Our Human Health Division maintains a "patient first, profits later" ideology. The organization is comprised of sales, marketing, market access, digital analytics and commercial professionals who are passionate about their role in bringing our medicines to our customers worldwide

Who we are

Merck & Co., Inc., Kenilworth, New Jersey, USA is known as "Merck" in the United States, Canada & Puerto Rico. We are known as "MSD" in Europe, Middle East, Africa, Latin America & Asia Pacific. We are a global biopharmaceutical leader with a diverse portfolio of prescription medicines, oncology, vaccines and animal health products.

We are driven by our purpose to develop and deliver innovative products that save and improve lives. With 69,000 employees operating in more than 140 countries, we offer state of the art laboratories, plants and offices that are designed to Inspire our employees as we learn, develop and grow in our careers. We are proud of our 125 years of service to humanity and continue to be one of the world's biggest investors in Research & Development.

What we look for

In a world of rapid innovation, we seek brave Inventors who want to make an Impact in all aspects of our business, enabling breakthroughs that will affect generations to come. We encourage you to bring your disruptive thinking, collaborative spirit and diverse perspective to our organization. Together we will continue Inventing For Life, Impacting Lives while Inspiring Your Career Growth.





In accordance with Managers' Policy

  • Job Posting and Employee Placement, all employees subject to this policy are required to have a minimum of twelve (12) months of service in current position prior to applying for open positions.

If you have been offered a separation benefits package but have not yet reached your separation date and are offered a position within the salary and geographical parameters as set forth in the Summary Plan Description (SPD) of your separation package, then you are no longer eligible for your separation benefits package. To discuss in more detail, please contact your HRBP or Talent Acquisition Advisor.

If you need an accommodation for the application process please email us at staffingaadar@merck.com

For more information about personal rights under Equal Employment Opportunity, visit:

EEOC Poster

EEOC GINA Supplement

OFCCP EEO Supplement

OFCCP Pay Transparency Rule

We are an equal opportunity employer, Minority/Female/Disability/Veteran proudly embracing diversity in all of its manifestations.

Search Firm Representatives Please Read Carefully

Merck & Co., Inc., Kenilworth, NJ, USA, also known as Merck Sharp & Dohme Corp., Kenilworth, NJ, USA, does not accept unsolicited assistance from search firms for employment opportunities. All CVs / resumes submitted by search firms to any employee at our company without a valid written search agreement in place for this position will be deemed the sole property of our company. No fee will be paid in the event a candidate is hired by our company as a result of an agency referral where no pre-existing agreement is in place. Where agency agreements are in place, introductions are position specific. Please, no phone calls or emails.

Employee Status:




VISA Sponsorship:


Travel Requirements:

Flexible Work Arrangements:

Not Specified


  • Day

Valid Driving License:


Hazardous Material(s):

Number of Openings:

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Oncology Medicare Account Executive Southeast Territory

Merck & Co., Inc.