Job Description:Job PurposeThe Patient Access Manager (PAM) - Central I is a non-sales regional, field-based position that will work directly with patients, families, and their provider(s) to address barriers, through information and education, to patient starting on therapy and staying on therapy, if appropriate. This role demonstrates superior customer facing skills working directly with multiple external and internal stakeholders including patients, prescribers, and advocacy groups. The PAM I demonstrates superior knowledge of insurer's prior authorization process to identify and resolve issues impacting treatment initiation and ongoing therapy. The PAM I will provide patient education, disease state and product education as well as general support for the patients and their caregivers. This role will appropriately interact and engage with internal and external teams but will serve as the point person responsible for identifying and resolving issues impacting treatment initiation and ongoing therapy. This position will also serve as the primary source for all regional patient advocacy activities.
Essential Job Functions- Upon confirming a valid consent, meet and work closely with patients/families to work through the steps required to gain access to therapy (insurance navigation, understanding of payer policy and procedure for prior authorization, denial appeals, disease and product education, site of care logistics, and other support services).
- Provide education and information through the prior authorization/appeal processes and coordinate the delivery of appropriate documentation to achieve and maintain coverage.
- Develop and offer solutions to the family, when necessary, that may also include communication of alternative insurance options and how families can best connect to available resources including charitable organizations such as PAF and NORD.
- Appropriately interact with and engage internal teams including commercial and medical and external teams including patients and/or their caregivers; payers; specialty pharmacy, physician offices, charitable organizations and patient advocacy organizations; Serve as the point person responsible for identifying and resolving issues impacting treatment initiation and ongoing therapy
- Provide support for the caregivers and collaborate with them in a way that allows for forward progress.
- Be knowledgeable of any changes in the payer access environment to identify issues that may impact access and communicate information appropriately to colleagues.
- Maintains up-to-date knowledge on product resources available to support patients/caregivers at the regional level and applies this knowledge in a way that supports patient care.
- Work within pre-determined processes to facilitate the conversion of referrals to prescriptions for Xeris marketed products in full compliance with relevant regulations and policies.
Skills and Qualifications- Bachelor's Degree in Health Sciences, Business/Marketing, Nursing or related field; Advanced degree preferred or equivalent combination of education, training, and experience.
- Must have a valid US-State issued driver's license
- Prefer a minimum of 3 years of business experience in the healthcare or biotech industry. Ultra-rare disease experience a plus.
- Experience working directly with patients and caregivers and in rare disease experience a plus.
- Experience should include insurance reimbursement, prior authorization and appeals, patient assistance programs, and billing and coding.
- Knowledge of Commercial payers, Medicare, and Medicaid reimbursement processes required.
- Experience administering self-insured medical plans in a corporate environment, liaising between participants and insurance carriers and assisting in the prior-authorization process is a plus.
- Must be familiar with relevant legal and regulatory environment in biotech industry such as the Food Drug and Cosmetic Act, Anti-Kickback Stature, HIPAA and other patient privacy guidance and regulations.
- Ability to navigate difficult conversations and handle sensitive issues with opposing opinions.
- A valid, US state-issued driver's license is required as occasional driving to client locations is a core requirement of this position.
- Competencies: Customer Service focus, Teamwork & Collaboration, Attention to Detail, Self-Starter, Problem Solving, Organizational skills, Adaptability, Professionalism, Written and Verbal Communications.
Working Conditions- Position may require periodic evening and weekend work, as necessary to fulfill obligations.
- Frequent travel up to 20% domestically.
- Must be able to support regional geographies and time zones.
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Direct Employers Posting: Houston, TX; Chicago, IL
The anticipated base salary range for this position is $96,000 - $140,800
We are committed to offering competitive compensation. Starting pay is determined based on a variety of factors, including the role, job-related knowledge, skills, experience, education, internal equity, market data, and the location of the role, where applicable.
The level of the position will be determined based on the selected candidate's qualifications and experience. Final determination of the actual base salary offered depends on several factors, including but not limited to the candidate's skills, experience, education, location, and business needs. Employees are eligible for equity or long-term incentive awards, where applicable. Field Sales role employees are eligible for a quarterly commission structure. Non-Sales role employees are eligible for an annual bonus. The Company also offers a comprehensive benefits package that includes additional elements such as paid time off benefits, various health, vision, and dental insurance options, 401(k) retirement benefits and more for eligible employees. Details about these and other offerings will be provided at the time a conditional offer of employment is made. Candidates are always welcome to inquire about our compensation and benefits package during the interview process. Individuals hired as temporary employees, interns, and preceptors are not eligible for commissions, bonuses, and/or long-term incentive or equity awards. Eligibility for other benefits will be based on plan documents.
Accessibility & Reasonable AccommodationsIf, because of a medical condition or disability, you require a reasonable accommodation or assistance to complete any part of the application process, please send an e-mail to [redacted] and identify the type of accommodation or assistance you are requesting. Please include the job requisition number in your message. Please note if your request is not for this stated purpose, you will not receive a response to your email. Do not include any medical or health information in this email.
