Patient Access Manager

This is a fully remote position, open to applicants in New Jersey, +2 more states.

📋 Description

• Act as a vital contact for reimbursement and acquisition logistics related to high-touch biologic and testosterone products.

• Oversee patient assistance and reimbursement support services.

• Provide education to patients regarding Buy/Bill processes, patient assistance, reimbursement, Specialty Pharmacy logistics, and steps in their treatment journey.

• Collaborate with Keenova patient support services representatives, FRMs, Case Managers, healthcare provider offices, specialty pharmacies, and internal teams.

• Analyze challenges in acquisition, reimbursement trends, affordability issues, payer dynamics, and patient access data.

• Address Specialty Pharmacy problems and work alongside FRMs to resolve client-related concerns.

• Identify barriers—both patient-specific and systemic—that hinder treatment initiation and continuity of care.

• Act as the patient advocate and represent the Voice of the Patient.

• Convert insights from the patient journey and field intelligence into strategic recommendations for leadership and organizational decision-making.

• Identify root causes of access barriers and suggest operational, systemic, and process enhancements.

• Assess and enhance patient support programs, educational resources, access pathways, and service offerings.

• Engage in pilot programs, launch readiness tasks, and strategic patient support initiatives.

• Present access trends, reimbursement challenges, and findings on patient experiences to internal stakeholders.

• Collaborate on new technologies, digital engagement tools, and innovative service models.

• Ensure adherence to company policies, HIPAA, FDA regulations, and relevant regulatory guidelines.

⛳️ Requirements

• A BS degree or equivalent is required; an MBA or advanced degree is preferred.

• 8-10 years of relevant experience in the Biopharma industry is required.

• A minimum of 5 years of reimbursement experience is essential.

• Previous experience with Keenova relationships is advantageous.

• Proficient in resolving complex reimbursement, affordability, and access issues across various payer channels.

• Capability to influence cross-functional stakeholders without having direct authority.

• Experience in identifying systemic access trends and translating insights into actionable business recommendations.

• Understanding of the global payer and distribution landscape, particularly regarding biologic In-Office Injectables in the U.S.

• Familiarity with coverage, coding, payment, and reimbursement requirements and policies.

• Knowledge of Local Coverage Determinations (LCDs) for regional MACs.

• Experience with Medicare billing/coding and appeals; ASP, WAC, Sequestration, and Medicare EOBs.

• Understanding of legislative, legal, and regulatory environments.

• Familiarity with buy-and-bill and Specialty Pharmacy channels.

• Knowledge of HIPAA requirements and FDA regulations.

• Proficiency in business analytics.

• Excellent written and verbal communication skills.

• Hands-on operational reimbursement experience; experience with both in-house and outsourced models is desirable.

• Ability to collaborate effectively with patients, FRMs, Case Managers, and cross-functional teams.

• Up to 30% travel may be required.

🏝️ Benefits

• Competitive salary and benefits through Keenova’s Total Rewards package.

• Eligibility for bonuses according to the applicable program.

• Up to 30% travel may be required.