Patient Support Specialist, Patient Access - West

April 9

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PharmaEssentia

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Better Science, Better Lives.

Biologics • Oncology • Rare Disease • Orphan Drugs • Orphan Disease

201 - 500

Description

• Lead the case management process, while balancing the needs of individual patients and aligning with department goals and objectives. • Act as primary patient support to ensure a seamless and personalized patient experience. • Engage patients/families to create a trusting relationship, uncover patient needs, understand challenges, and provide education and support. • Educate patients/caregivers and other collaboration members about SOURCE, insurance requirements or limitations, assistance programs, disease specific organizations and relevant disease/product information as necessary to support access. • Consistently identify complex patient specific issues and provide relevant education and resources to patients with goal of empowering patients to identify and initiate an action plan to eliminate any access barriers. • Work collaboratively with all access stakeholders to ensure all available resources have been activated to address access barriers. • Identify and complete follow up calls at critical points in patient journey to provide additional support and resources, until identified access barriers are eliminated. • When eligible, educate and enroll patients in assistance programs available through SOURCE. Monitor to ensure continued eligibility. • Consistently maintain accurate data, including case updates and next steps, new insurance information or coverage approvals, for all patient interactions. Leverage CRM functions and reporting tools to manage caseload and prioritize patient needs. • Coordinate communication between the Manager of Patient Access, Field Access Manager, Case Manager and Specialty Pharmacy and notify of case updates that require their action via identified process. • Demonstrate and maintain an understanding of HUB Business rules, patient journey and HUB communication documents for patients and HCPs. • Provide caseload coverage outside of assigned territory as needed. • Establish and maintain professional and effective relationships with all internal and external stakeholders including but not limited to HUB, specialty pharmacies and market access colleagues. • Represent SOURCE and serve as a subject matter expert at external meetings and conferences on an as needed basis. • Demonstrate and maintain an understanding of the role for all market access colleagues, patient access goals, and patient support services at HUB and specialty pharmacy. • Demonstrate innovation by consistently monitoring systems, processes, and potential gaps by offering new ideas and solutions to elevate the patient support program. • Maintain a comprehensive understanding of navigation of health care systems, pharmacy and medical coverage, insurance plan types & payer trends. • Effectively identify and share new trends or other knowledge that could negatively impact BESREMi access with the Patient Access leadership team. • Comply with laws, regulations and rules governing the pharmaceutical industry.

Requirements

• Bachelor’s degree required. • Degree in health care, social work, or case management (or equivalent professional experience in a health care or insurance setting). • Minimum 3-5 years of experience in a patient facing or case management role. • In-depth understanding of health insurance benefits, relevant state and federal laws and insurance regulations. • Proficiency in billing/coding, insurance plan types, medical and pharmacy benefits, and relevant state and federal laws and insurance regulations preferred. • Experience with financial assistance programs, charitable access and related resources preferred. • Proven ability to collaborate with internal and external stakeholders. • Prior experience in oncology or rare disease/specialty therapies or relatable experience. • Experience with Salesforce CRM preferred. • Excellent attention to detail, organizational skills and ability to multi-task and deliver results in a fast-paced environment. • Ability to appropriately represent the patient access team in all internal and external settings. • Willingness to travel up to ~25% domestically. • Strong interpersonal skills including the ability to listen actively and synthesize information in a meaningful way. • Strong analytical capabilities to ensure robust inputs to decision-making. • Excellent communication (verbal and writing) skills with proven ability to present to large and small audiences. • Good judgment, and ability to adapt and change in a shifting environment. • Strategic, passionate, self-starter who takes initiative.

Benefits

• Comprehensive medical coverage: 80% employer paid • Dental and vision coverage: 90% employer paid • Vision coverage: 100% employer paid • Generous paid time-off • 401(k) retirement plan with competitive company match • Medical & Dependent Care Flexible Spending Account • Up to $150 monthly cell phone reimbursement • Employee Assistance Program