Market Access Specialist, I – II

Stelle nicht auf LinkedIn

🕒 vor 3 Tagen

🏄 California – Remote

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💵 $75.000 - $100.000 / Jahr

⏰ Vollzeit

🟢 Junior

🟡 Mittelstufe

🚫👨‍🎓 Kein Abschluss erforderlich

🦅 H1B-Visum-Sponsor

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👻 Geisterscore 0%

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🗣️🇺🇸🇬🇧 Englisch erforderlich

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Logo of SetPoint Medical

SetPoint Medical

51 - 200 Mitarbeiter

🏭 Fertigung

🏥 Gesundheitswesen

🧬 Biotechnologie

Manufacturing • Healthcare • Biotechnology

SetPoint Medical ist ein privat geführtes, klinisches Gesundheitsunternehmen, das sich der Behandlung von Patienten mit Autoimmunerkrankungen widmet. Das Unternehmen entwickelt eine neuartige Plattform, die darauf abzielt, den Vagusnerv zu stimulieren, um angeborene entzündungshemmende Wege zu aktivieren und so einen systemischen immunsystemrestaurativen Effekt zu erzielen. Die Plattformtechnologie von SetPoint Medical soll Patienten und Anbietern eine Behandlungsalternative zu Rheumatoider Arthritis, entzündlichen Darmerkrankungen und anderen chronischen Autoimmunerkrankungen bieten, mit potenziell geringerem Risiko und Kosten im Vergleich zur medikamentösen Therapie.

Beschreibung

• Facilitate patient access to support the launch of SetPoint Therapy, the first neuroimmune modulation therapy to treat rheumatoid arthritis in the United States • Manage the pre-service clearance and prior authorization process for patients seeking access to SetPoint Therapy • Engage with patients, rheumatology providers, neurosurgery practices, and hospitals to ensure a smooth pre-service clearance process • Provide customer support to providers, HCO support staff, patients, and internal teams • Review and log incoming medical record documentation and provide feedback to providers where necessary • Verify medical benefits and facilitate the prior authorization process for company products • Coordinate the pre-service appeals process, including composing appeals • Establish relationships with referring rheumatology practices, neurosurgery providers, hospitals, and health systems • Identify payer behaviors, actions, and trends that inform the prior authorization approach • Complete corporate administrative and training requirements accurately and on time • Maintain company ethical, moral, and professional standards • Market Access Specialist I: Execute defined access programs with moderate guidance and support payer account management • Market Access Specialist II: Independently manage payer accounts or access workstreams and own territory-level outcomes • Report to the Market Access Manager

🎯 Anforderungen

• 2+ years of relevant experience, depending on level • Experience working in prior authorization and/or a pre-service clearance function at a medical device/pharmaceutical company, healthcare provider, or third-party market access service provider • Excellent interpersonal communication skills • Skilled in appeal composition and/or persuasive writing • Understanding of medical practice management, including prior authorization portals, NPIs, electronic health records, and patient/provider releases • Knowledge of prior authorization appeal processes including external review, state fair hearing, and ALJ • Awareness of State and Federal laws affecting patient and provider appeal rights, external review protocols, and URAC standards • Experience with HIPAA compliance standards for covered entities • Understanding of prior authorization workflows and ability to learn and use systems such as Salesforce, EPIC, and Cerner • Ability to work independently • Proven ability to manage complexity and reprioritize work to drive efficiency and outcomes • Demonstrated ability to understand trends, identify issues, and develop corrective actions • Ability to thrive in a fast-paced, dynamic startup environment and adapt to changing priorities and market conditions • Passion for improving patient outcomes and commitment to the company’s mission and values • Ability to perform routine physical tasks, including lifting up to 20 pounds • Prolonged periods of sitting at a desk and working on a computer • Must have and maintain authorization to work in the United States

🏖️ Vorteile

• Fully remote work arrangement • Occasional travel up to 10%, including travel to Company Headquarters in Valencia, CA • Equal opportunity employer and commitment to diversity

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