Regional Patient Access Manager

This is a fully remote position, open to applicants in Virginia.

📋 Description

• Deliver field access support services and education to healthcare professionals to enhance patient access and expedite treatment timelines.

• Engage with Specialty Pharmacies, Closed Door Pharmacies including Genoa, and Patient-Physician Services HUB partners for products marketed in the U.S.

• Establish and maintain the pharmacy distribution network by performing vetting tasks within the designated geography, including approval, denial, and removal communications.

• Assist and educate healthcare provider entities on coverage matters, access support services, processes, forms, and patient financial assistance programs.

• Act as a subject matter expert on regional and national payer coverage policies and procedures.

• Collaborate cross-functionally with field sales, network pharmacies, market access, commercial analytics, operations, and Payer Marketing.

• Develop relationships with pharmacies, physicians, office personnel, and other healthcare providers to address coverage issues for prescriptions already in process.

• Train and inform healthcare providers on payer-specific coverage policies, documentation requirements, appeals processes, and patient financial assistance programs.

• Introduce electronic Patient Access submission technologies such as CoverMyMeds and assist with prior authorization, letters of medical necessity, appeals, step edits, and formulary exception requests.

• Resolve coverage and patient access issues through effective problem-solving and case resolution.

• Identify and communicate payer-related issues to National Account Directors.

• Interact with local closed-door and long-term care pharmacies.

• Relay opportunities and challenges associated with patient access issues to management.

• Present payer coverage insights during internal business reviews and national/regional sales meetings.

• Conduct Patient Access workshops at POA meetings and contribute to new-hire training.

• Oversee pharmacy distribution processes, recommend workflow improvements, and share specialty distribution best practices.

• Foster a diverse and inclusive work environment free from discrimination and harassment.

• Carry out additional duties as assigned.

⛳️ Requirements

• BS/BA degree in a relevant field AND 6+ years of experience in pharma/biotech commercial roles, including 2+ years in specialty pharmacy/market access; OR a Master’s degree or MBA with 4+ years of relevant experience; OR a PharmD or PhD with 2+ years of relevant experience.

• Experience with specialty products, preferably in CNS.

• Comprehensive understanding of specialty pharmacies, managed care, pharmacy benefit managers, and government payers.

• In-depth knowledge of patient support programs, reimbursement support, and financial assistance adherence programs.

• Strong grasp of the prescription adjudication process.

• Ability to articulate payer coverage criteria and prior authorization processes.

• Awareness of current issues within the marketplace, the pharmaceutical industry, and the national healthcare system.

• Willingness to travel overnight up to 60% of the time.

• Familiarity with best practices in the functional discipline and associated business areas.

• Capability to enhance tools and processes within the functional area.

• Proven ability to work collaboratively and lead multiple teams.

• Demonstrated leadership skills, typically overseeing lower levels and/or indirect teams.

• Proficient computer skills.

• Excellent communication, problem-solving, and analytical thinking abilities.

• Competence in meeting multiple project deadlines accurately and efficiently.

• Strong project management skills with the ability to thrive in a cross-functional environment while managing multiple tasks.

• Outstanding interpersonal skills and success in cross-functional teamwork.

🏝️ Benefits

• Annual bonus with a target of 30% of earned base salary.

• Eligibility to participate in an equity-based long-term incentive program.

• Retirement savings plan with company match.

• Paid vacation, holidays, and personal days.

• Paid caregiver/parental and medical leave.

• Comprehensive medical, prescription drug, dental, and vision coverage.