Senior Therapy Access Manager

PRIMARY DUTIES AND RESPONSIBILITIES:

• Execute institutional and field access strategy for their responsible geography
• Identify and educate key clinic/institution stakeholders on reimbursement dynamics, patient support services, distribution model, and payer requirements to gain access to the product
• Partner with the Sales Account Managers, Clinical Coordinators, and Patient Support Services Hub to ensure HCPs can navigate patient access needs; lead proactive touchpoints with internal matrix partners to keep all parties informed for relevant account planning purposes 

• Conduct/monitor complex Benefits Investigations, provide results to clinics, and educate on Prior Authorization processes. Monitor PA process and provide additional education as needed.

• Act as a liaison between the patient support services hub and the HCP clinic to educate providers on patient support programs. This will include educating the staff at the institution or clinic that is responsible for managing all aspects of patient access to therapy utilizing BioMarin resources including, but not limited to coverage authorization guides, Co-Pay assistance programs and other hub and patient support services 
• Provide live one-on-one educational support to HCP and/or office staff and address questions about coverage requirements, including education on the payers’ coverage authorization requirements and process
• May reactively interact with patients for complex access issues as needed while maintaining compliance standards at all times
• Champion compliance and ethical standards, mentoring junior team members on best practices within a regulated environment
• Analyze payer trends and institutional feedback to inform strategic adjustments and support escalation pathways for challenging cases
• Educate HCPs, office staff, and institutions on payer issues, policies/guidelines, trends, common reasons for PA delays, denials, and appeal processes
• Review escalated individual patient cases to identify and address any coverage barriers; proactively scan payer policies tailored to each clinic’s needs and provide regular updates based on market dynamics 
• Travel up to 50% to support above responsibilities, as needed; represent team at national meetings as appropriate

EXPERIENCE AND EDUCATIONAL REQUIREMENTS:

• 7+ years of Pharmaceutical or Healthcare industries, preferably including 5+ years in access/reimbursement
• Bachelor’s degree required
• Proven track record of supporting HCPs and office staff in seeking access/reimbursement that required significant payer and reimbursement support
• Experience with both ‘buy and bill’ and Specialty Pharmacy distribution pathways for specialty oral and injectable medications
• Strong knowledge of the payer environment, including but not limited to: government and commercial payers, assignment of benefits, letter of agreements, accumulators, maximizers, manufacturer patient support programs
• Ability to professionally interact with customers – HCPs, office staff, institutions
• Excellent communication skills; strategizes proactive solutions for keeping stakeholders informed
• Solid knowledge of patient support programs including HUB programs, co-pay assistance programs, and nurse educator support
• Track record of effective collaboration in a highly matrixed environment
• Strong knowledge and understanding of Compliance with HIPAA regulations, OIG guidance, Advertising and Promotion requirements, the Anti-Kickback Statute, and applicable policies, best practices, and guidelines
• Strong planning and organization skills including OFFICE suite of productivity tools
• Rare Disease, Specialty, and Launch experience

PREFERRED EXPERIENCE

• Experience working within Salesforce.com
• Experience with REMS product(s)
• Experience with limited distribution product(s)

MINIMUM SKILLS, KNOWLEDGE, AND ABILITY REQUIREMENTS:

• Strong analytical skills.
• Strong organizational skills; attention to detail.
• Ability to travel overnight
• Ability to schedule individual work-related travel (air, hotel, rental car as needed).
• Ability to utilize own car for travel.
• Technical knowledge of healthcare from a patient and provider perspective (miscellaneous codes, billing codes, appeals process)

 
Must be willing to travel up to 50% of the time.  Territory includes entire US and Puerto Rico.

Bilingual highly desirable.
Nursing experience a plus.

We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity, sexual orientation, national origin, disability status, protected veteran status, or any other characteristic protected by law.