Patient Access Manager

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

📋 Description

• Act as a key contact for reimbursement and acquisition logistics for high-touch biologic, orphan-disease, and testosterone products.

• Oversee patient assistance and reimbursement support services.

• Provide education to patients regarding Buy/Bill, Specialty Pharmacy logistics, reimbursement, acquisition, and financial assistance resources.

• Collaborate with representatives from the Keenova patient support program.

• Examine acquisition and reimbursement data to pinpoint logistical challenges and escalate cases as necessary.

• Address Specialty Pharmacy issues with both internal and external stakeholders.

• Work alongside Field Reimbursement Managers, case managers, provider offices, and specialty pharmacies to overcome access barriers.

• Gather, analyze, and consolidate field intelligence on patient access, reimbursement, affordability, healthcare systems, and patient experiences.

• Convert insights from the patient journey and reimbursement trends into strategic recommendations.

• Identify underlying causes and trends affecting access and suggest operational and systemic enhancements.

• Serve as a subject matter expert in patient access and reimbursement.

• Act as the intermediary between patients, providers, specialty pharmacies, and internal stakeholders.

• Advise Patient Access leadership on access trends, operational opportunities, and challenges within healthcare.

• Facilitate ongoing improvements, pilot programs, launch readiness, and strategic patient-support initiatives.

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

• Present access trends, reimbursement challenges, and findings on patient experience to internal stakeholders and senior leadership.

• Advocate for patients by identifying unmet needs, access challenges, and obstacles in the treatment journey.

• Create tailored strategies to ensure timely treatment initiation and continuity of care.

• Empower patients and caregivers through education, resource awareness, and navigation support.

⛳️ Requirements

• A BS or equivalent is mandatory; 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 necessary.

• Prior experience with Keenova relationships is advantageous.

• Proficiency in resolving complex reimbursement, affordability, and access challenges across various payer channels is essential.

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

• Experience in identifying systemic access trends and transforming observations into actionable business recommendations.

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

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

• Understanding of Local Coverage Determinations for Keenova products as set by regional MAC.

• Awareness of Medicare billing/coding and appeal procedures, ASP, WAC, Sequestration, and Medicare EOBs.

• Comprehension of legislative, legal, and regulatory contexts.

• Knowledge of buy-and-bill and Specialty Pharmacy channels.

• Understanding of HIPAA regulations and FDA guidelines.

• Strong communication skills with the ability to convey complex information in a clear and actionable manner.

• Proficiency in business analytics.

• Excellent written and verbal communication abilities.

• Capacity to formulate strategic plans for product access.

• Ability to work collaboratively across functions.

• Hands-on operational reimbursement experience is a plus.

• Ability to collaborate with both field-based and home office personnel.

• Adherence to Keenova policies is required.

• Up to 30% travel may be necessary.

🏝️ Benefits

• Competitive salary and comprehensive benefits.

• Eligibility for bonuses in line with the applicable program.

• Up to 30% travel may be necessary.