Regional Patient Access Manager – Long Term Care

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

📋 Description

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

• Liaise with specialty pharmacies, closed-door pharmacies including Genoa, and the HUB partner concerning marketed products in the U.S.

• Evaluate pharmacies within the designated area and communicate decisions regarding approval, denial, or removal from the distribution network.

• Assist and inform healthcare professionals on coverage challenges, access support services, payer-specific coverage matters, and patient financial assistance programs.

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

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

• Develop and maintain relationships with pharmacies, physicians, office personnel, and other healthcare professionals to address coverage issues.

• Educate healthcare professionals about coverage policies, documentation requirements, appeals procedures, and patient assistance programs.

• Introduce technological solutions such as CoverMyMeds for electronic patient access submissions.

• Clarify payer criteria, prior authorizations, letters of medical necessity, appeals, step edits, formulary exceptions, and related documentation requirements.

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

• Identify and relay payer issues to the National Account Directors team.

• Provide support and guidance to local closed-door and long-term-care pharmacies.

• Communicate patient access opportunities and challenges to management.

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

• Conduct Patient Access workshops and assist with onboarding training for new hires.

• Build and sustain the pharmacy distribution network through evaluations and operational monitoring.

• Strive to maintain a diverse and inclusive environment free from discrimination and harassment.

• Perform additional duties as assigned.

⛳️ Requirements

• BS/BA degree in a relevant field and over 6 years of pharma/biotech commercial experience, including at least 2 years in specialty pharmacy/market access.

• Master’s degree or MBA with 4+ years of related experience (Master’s degree or MBA is preferred).

• PharmD or PhD with a minimum of 2 years of relevant experience.

• Experience with specialty products, particularly in CNS is preferred.

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

• Strong knowledge of patient support programs, reimbursement assistance, and financial aid adherence programs.

• In-depth understanding of prescription adjudication processes.

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

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

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

• Familiarity with best practices within the functional discipline and related business areas.

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

• Ability to collaborate as part of and lead multiple teams.

• Leadership qualities and the ability to guide lower-level and/or indirect teams.

• Proficient computer skills.

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

• Capacity to meet multiple deadlines accurately and efficiently.

• Ability to operate in a cross-functional environment and manage multiple tasks.

🏝️ Benefits

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

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

• Retirement savings plan with company matching contributions.

• Paid vacation.

• Paid holidays.

• Paid personal days.

• Paid caregiver/parental leave.

• Paid medical leave.

• Medical coverage.

• Prescription drug coverage.

• Dental coverage.

• Vision coverage.

• Remote work arrangement.