Patient Access Liaison- Krystexxa - Birmingham AL (Rare Disease)

Role Summary

The Patient Access Liaison (PAL) for KRYSTEXXA in Rare Disease provides logistical, non-medical educational support to patients, caregivers, and site of care staff to facilitate access to therapy. The PAL has strong knowledge of access and reimbursement for buy-and-bill/infused pharmaceutical products and works in a high-visibility, team-based environment to educate on steps to gain access and support ongoing therapy adherence. The role partners with cross-functional teams to improve patient access to insurance, financial assistance, resources, and more. Travel up to 50% may be required.

Responsibilities

• Secure written or electronic patient HIPAA for patients in the assigned geography
• Develop relationships with patients and caregivers by engaging via phone, text, email, virtual or in person connections
• Assess individual needs of the patient and develop an appropriate education and resource plan of action, considering the patient’s family and team of healthcare providers to empower the patient to become their own advocate
• Educate the patient on KRYSTEXXA coverage based on their benefits and the steps needed to gain prior authorization to ensure understanding of the process for medication access
• Provide information on co-pay assistance programs, national foundations, and free drug programs by sharing information to patients as appropriate and needed
• Provide proactive education to prescribers and sites of care upon patient enrollment on coverage for Horizon rare disease therapies, common prior authorization requirements, and coding and billings requirements
• Provide access and reimbursement education based on the enrolled patient’s KRYSTEXXA benefits to physician offices and sites of care
• Educate the physician office and/or SOC on KRYSTEXXA coverage based on the patient’s benefits and the steps needed to gain prior authorization to ensure understanding of the process for medication access
• Investigate access challenges pre and post-infusion to include support for denied claims and claim reviews
• Partner with Safety and PV and report AE’s and product complaints through medical information.
• Work closely with the Horizon cross functional team including Case Managers, the Site of Care team, market access, matrix partners and external vendors
• Adhere to professional standards compliance guidance, policies and procedures, federal, state, and local requirements

Qualifications

• Required: Doctorate degree and 2 years of patient services, and/or access and reimbursement, experience
• Required: Master’s degree and 4 years of patient services, and/or access and reimbursement, experience
• Required: Bachelor’s degree and 6 years of patient services, and/or access and reimbursement, experience
• Preferred: Scientific background and ability to learn product and disease information
• Preferred: Nursing or other clinical background a plus
• Preferred: Access and reimbursement for buy and bill products
• Preferred: Orphan or Rare disease experience
• Preferred: Familiarity with HIPAA guidelines and FDA requirements
• Preferred: Familiarity with and Adherence to internal and OIG Compliance guidelines a must
• Preferred: Ability to handle difficult patient cases and resolve hurdles
• Preferred: Ability to work in team environment and manage communication with case Liaisons and sales reps
• Preferred: Ability to respond immediately when necessary (within 24 hours) to prevent lapses in treatment
• Preferred: Strong analytical skills and ability to report on meaningful activity in the region
• Preferred: Proficient in Microsoft Office
• Preferred: Professional, proactive demeanor
• Preferred: Strong interpersonal skills and strategic mindset
• Preferred: Excellent written and verbal communication skills

Additional Requirements

• Travel: Potential for up to 50% travel, including some overnight and weekend commitments