Patient Access Liaison - KRYSTEXXA- Philadelphia

Role Summary

Role: Patient Access Liaison for KRYSTEXXA in Rare Disease. Provide logistical, non-medical educational assistance to patients, caregivers, and office/site-of-care staff; support access and reimbursement processes for buy-and-bill/infused therapies; build and maintain relationships with patients, families, physicians, and cross-functional teams to facilitate ongoing therapy access and adherence.

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 patient needs and develop an appropriate education and resource plan of action, involving family and healthcare team to empower patient advocacy
• Educate patients on KRYSTEXXA coverage based on benefits and steps to gain prior authorization to ensure understanding of medication access
• Provide information on co-pay assistance programs, national foundations, and free drug programs as appropriate
• Provide proactive education to prescribers and sites of care at patient enrollment on coverage for Horizon rare disease therapies, prior authorization requirements, and coding/billing requirements
• Provide access and reimbursement education based on the patient’s KRYSTEXXA benefits to physician offices and sites of care
• Educate physician offices/SOC on KRYSTEXXA coverage based on patient benefits and steps to gain prior authorization
• Investigate access challenges pre- and post-infusion, including support for denied claims and claim reviews
• Partner with Safety and PV to report adverse events and product complaints
• Work closely with cross-functional teams including Case Managers, Site of Care, market access, matrix partners, and external vendors
• Adhere to professional standards, compliance guidance, policies and procedures, and regulatory requirements

Qualifications

• Required: Doctorate degree and 2 years of patient services and/or access and reimbursement experience; OR Master’s degree and 4 years of patient services and/or access and reimbursement experience; OR 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; Nursing or clinical background a plus; Access and reimbursement for buy-and-bill products; Orphan or Rare disease experience; Familiarity with HIPAA guidelines and FDA requirements; Familiarity with internal and OIG Compliance guidelines; Ability to handle difficult patient cases and resolve hurdles; Ability to work in a team environment and manage communication with case liaisons and sales reps; Ability to respond within 24 hours to prevent lapses in treatment; Strong analytical skills; Proficiency in Microsoft Office; Professional, proactive demeanor; Strong interpersonal and strategic thinking; Excellent written and verbal communication; Travel up to 50% with some overnight and weekend commitments

Skills

• Customer service excellence
• Clear, proactive communication with patients, caregivers, and healthcare professionals
• HIPAA compliance and privacy awareness
• Problem-solving and advocacy to navigate insurance and reimbursement
• Cross-functional collaboration
• Analytical reporting and data awareness

Education

• Doctorate or Master’s or Bachelor’s degree as indicated in qualifications

Additional Requirements

• Potential travel up to 50%, including overnight and weekend commitments