Patient Access Manager

Job Title
Patient Access Manager

Requisition



Location

Bridgewater, NJ

Additional Locations

Hazelwood, MO, Malvern, PA
Job Description Summary
The Patient Access Manager (PAM) is a critical front-line member of the Keenova Patient Support Services team who represents Keenova's commitment to improving the patient experience by supporting patients, caregivers, healthcare providers, and internal stakeholders throughout the treatment journey. The PAM serves as a trusted resource and subject matter expert, providing education, support, navigation assistance, and hands-on guidance related to treatment access, reimbursement, affordability, and patient support services.
Having gained significant experience in patient access, reimbursement, patient support services, and healthcare navigation, the PAM possesses the ability to synthesize complex information and apply it to improve patient outcomes, reduce access barriers, and enhance the overall patient experience. The PAM effectively identifies patient-specific and systemic obstacles impacting treatment initiation and continuity of care and proactively collaborates with internal and external stakeholders to develop solutions that support timely patient access.
The PAM is proficient in analyzing patient access trends, reimbursement challenges, affordability concerns, and treatment journey insights. Using these insights, the PAM identifies opportunities for process improvement, patient support enhancements, and operational efficiencies that improve access outcomes. The PAM takes initiative to work collaboratively with patients, caregivers, provider offices, specialty pharmacies, case managers, and FRMs while ensuring solutions remain patient-centered, compliant, and aligned with organizational objectives. The PAM operates effectively as part of a cross-functional team to navigate complex patient situations and resolve access-related obstacles.
With minimal guidance, the PAM serves as a strategic voice of the patient, identifying emerging trends, unmet needs, healthcare literacy challenges, affordability barriers, and access obstacles that impact patient outcomes. The PAM translates these insights into actionable recommendations that support patient support strategy, operational improvements, resource allocation decisions, and future program design. Through expertise, influence, and collaboration, the PAM helps drive patient-centered solutions that improve treatment initiation, continuity of care, and overall patient experience.

Job Description

Key Responsibilities:

Patient Support

• Critical point person for all reimbursement and acquisition logistical aspects of a high touch biologic medication for an orphan disease, and testosterone products with multiple acquisition options within a changing payer landscape.
• Assists patients with questions related to Buy/Bill BI management. Educate/Assist with Specialty Pharmacy (SP) understanding, expectations and logistics. Continually educate patients on appropriate steps, educate on the importance of answering the phone throughout the journey to ensure there are no delays
• Primary responsibilities include:
• Managing patient assistance and reimbursement support services offered to patients and related to patient access buy/bill products.
• Coordinating with Keenova's patient support services program representatives, as needed
• Educating patients on the Buy/Bill process, patient assistance and reimbursement support services.
• Utilizing data to critically think through acquisition challenges from a variety of outlets including SP and Specialty Distributors
• Is proficient in business analytics and can use this to understand common logistical issues in accounts and escalate cases appropriately so that the FRM can proactively develop plans for remediation.
• Assist new patients from a reimbursement perspective to inform them about the reimbursement process as well as education on various MARC approved resources pertaining to reimbursement, acquisition and financial assistance.

Specialty Pharmacy (SP) Support

• Work closely with the external and internal customers to trouble shoot any SP related issues. PAM work closely with their FRM's to partner and manage any customer-related issues directly with the SP's.
• SP experience is critical. Each Senior Patient Access Engagement Manager should be an expert in SP logistics and operations.
• Must be able to analyze data and know how to make that data into actionable steps to facilitate patient access to Keenova products.
• Work closely with SP's to understand logistical issues that arise and provide MARC approved resources and programs to facilitate patient access as well as communicate with SP's to find resolutions to issues that arise at the SP.
• Identify gaps in knowledge of patients from a SP process and help provide education for the patient to better understand their role

Patient Experience, Insights & Strategic Impact:

• Collect, analyze, and synthesize field intelligence related to patient access, reimbursement, affordability, healthcare system dynamics, and patient experience to influence organizational decision making and patient support strategies.
• Serve as the voice of the patient and field-based access expert by translating patient journey insights, reimbursement trends, and healthcare system observations into strategic recommendations that influence organizational priorities, patient support models, and business planning initiatives.
• Identify trends and root causes impacting access and make recommendations to appropriate stakeholders for operational enhancements
• Serves as a recognized patient access and reimbursement subject matter expert within assigned case load
• Influences patient support, market access, and commercialization strategies through identification of reimbursement trends, payer dynamics, healthcare system barriers, and patient experience insights.
• Provides field intelligence that supports organizational decision-making, operational improvements, and patient-centered program evolution.
• Acts as a liaison between patients, providers, specialty pharmacies, and internal stakeholders to improve access effectiveness and patient knowledge.
• Acts as a strategic advisor to Patient Access leadership by identifying access trends, operational opportunities, and healthcare challenges that influence patient support strategy, resource allocation, and organizational priorities.
• Supports continuous improvement initiatives designed to reduce access barriers, accelerate treatment initiation, and enhance patient experience.
• Contribute to the development, refinement, and optimization of patient support programs, educational resources, and access-related initiatives.
• Evaluate patient journey challenges and recommend innovative solutions to improve patient engagement, treatment initiation, and barrier removal.
• Participate in pilot programs, launch readiness activities, and strategic initiatives designed to enhance patient support effectiveness.
• Synthesize complex field observations into actionable business insights for senior leadership.
• Present access trends, reimbursement challenges, and patient experience findings to internal stakeholders to support data-driven decision making.
• Identify root causes contributing to patient access barriers and recommend systemic solutions that improve operational performance and patient outcomes
• Evaluate the effectiveness of patient support programs and identify opportunities to optimize service offerings, improve patient experience, and enhance organizational performance.
• Identify opportunities to streamline access pathways, reduce treatment delays, and improve patient outcomes through innovative solutions and process improvements.
• Assess the potential impact of market access changes on patient experience and treatment access and provide recommendations for mitigation strategies.
• Recommend and champion process improvements that drive measurable enhancements in access outcomes, patient satisfaction, and operational efficiency.
• Participate in development of innovative patient engagement and support strategies that address evolving patient and healthcare system needs.
• Collaborate with leadership to evaluate emerging technologies, digital engagement tools, and service models that may improve access and patient experience.

Internal Partnerships

• Consistent, reliable, timely, and high-quality support for patients, caregivers, and internal stakeholders to ensure a seamless patient experience and reduce barriers to treatment access. Serves as a trusted resource throughout the patient journey while maintaining appropriate compliance and regulatory boundaries.
• Demonstrates leadership by establishing a patient-centered, solutions-oriented approach to identifying, escalating, and helping resolve access barriers impacting treatment initiation, continuity of care, affordability, and overall patient experience. Specific examples include:
• Identify patients experiencing complex access, reimbursement, affordability, healthcare literacy, or logistical challenges and develop individualized strategies to support timely treatment initiation and continuity of care.
• Partner with Case Managers, specialty pharmacies, provider offices, and FRMs to coordinate resources, remove barriers, and support positive patient outcomes.
• Serve as the patient's advocate by proactively identifying concerns, obstacles, and unmet needs and escalating issues appropriately to facilitate timely resolution.
• Gather and communicate actionable patient insights related to access barriers, affordability challenges, treatment journey obstacles, and healthcare literacy concerns to inform program enhancements and organizational decision-making.
• Identify trends impacting patient experience and treatment access and provide recommendations that support continuous improvement of patient support programs, operational processes, and patient engagement strategies.
• Empower patients and caregivers to navigate complex healthcare systems through education, support, resource awareness, and reinforcement of treatment journey milestones, promoting patient self-advocacy and informed decision-making.
• Act as the "Voice of the Patient" by translating patient experiences and access challenges into meaningful recommendations that influence patient support strategy, operational priorities, resource allocation, and future program design.
• Collaborate with internal stakeholders to evaluate patient support services, identify opportunities to improve the patient experience, reduce treatment delays, and enhance overall access effectiveness.
• Provide guidance to internal stakeholders regarding patient support program offerings, patient engagement best practices, and appropriate patient interactions consistent with company policies and compliance requirements

Advocacy:

• Serve as the "Voice of the Patient" by identifying recurring challenges, unmet needs, and treatment journey obstacles.
• Translate patient experiences into actionable recommendations for leadership, operations, training, and patient support programs.
• Identify systemic barriers affecting multiple patients and advocate for organizational changes that improve patient outcomes.
• Present patient insights and trends to leadership teams to influence program design, resource allocation, and patient support strategy.
• Recommend process improvements that reduce delays, improve adherence, and enhance the overall patient experience

Qualifications:

Education & Experience:

• BS or equivalent is required; MBA or advanced degree ideal.
• 8-10 years of relevant experience in the Biopharma industry required.
• 5 years of reimbursement experience required.
• Previous experience working with Keenova relationships desirable.
• Demonstrated expertise resolving highly complex reimbursement, affordability, and access challenges across multiple payer channels.
• Proven ability to influence outcomes across cross-functional stakeholders without direct authority.
• Experience identifying systemic access trends and translating observations into actionable business recommendations.

Knowledge:

• Systemic understanding of the global payer and distribution environment, in particular, biologic In-Office Injectables (IOI) in the U.S.
• Understanding of coverage, coding (diagnostic, procedural and product), payment and reimbursement requirements and policies.
• Knowledge / expertise in Local Coverage Determinations (LCDs) per each regional MAC for all Keenova products.
• Knowledgeable on Medicare billing/coding and appeal process. ASP, WAC as well as Sequestration; interpret and understand Medicare EOBs.
• Understands the legislative, legal and regulatory environments and anticipates potential impact to Keenova.
• Understanding of buy-and-bill channel
• Understanding of Specialty Pharmacy channel
• Knowledge of HIPAA requirements & FDA regulations
• Understands effective communication techniques, including when to guide a conversation and when to actively listen to encourage patient engagement and understanding.
• Possesses the ability to translate complex clinical, reimbursement, or program-related information into clear, simple, and actionable language.
• Demonstrates sound judgment in determining the appropriate level of detail for different audiences and situations, balancing high-level communication with in-depth discussion as needed.

Skills & Abilities:

• Ability to synthesize broad information and use this to more efficiently and effectively create positive change for patients and Keenova
• Is proficient in business analytics and can use this to understand common issues that patients encounter and ability to partner with FRM's when appropriate office intervention is required.
• Strong written and verbal communication skills, self-awareness and an ability to exercise self-control.
• Ability to work with patients, FRMs, Case Managers and others to develop strategic plans to manage issues related to product access
• Ability to operate as part of a cross-functional team to better collaborate when obstacles arise.
• Hands-on operational reimbursement experience - in-h