Regional Patient Access Manager - NP RPAM Mountain Plains

Role Summary

The Regional Patient Access Manager (RPAM) is responsible for providing field access support services and education to healthcare professionals to maximize patient access to company products and accelerate time to treatment, communicating with specialty pharmacies and HUB partners, and maintaining the integrity of the pharmacy distribution network through vetting and ongoing monitoring. The role requires cross-functional collaboration with field sales, market access, analytics, and operations, and involvement in payer coverage education and patient financial assistance programs.

Responsibilities

• Builds and sustains relationships with pharmacies, physicians and their office staff and other HCPs to help resolve coverage problems for written prescriptions already in process
• Works cross-functionally with field sales leadership and related departments to support patient access with specific payers
• Provides training and education to HCPs on payor-specific coverage policies and documentation requirements, appeals processes, and patient financial assistance programs
• Introduces technology options for electronic Patient Access submission, explains payer criteria, forms, processes, and provides support for related coverage issues and documentation requirements
• Problem solves and conducts case resolution and communicates effectively with field sales, HCPs, network pharmacies and HUB employees
• Identifies payer issues with the NAD team and interfaces with local closed-door/LTC pharmacies
• Communicates regularly with management on opportunities and challenges related to patient access
• Presents insight into payer coverage policies at internal reviews and regional meetings
• Conducts Patient Access workshops during POA meetings and assists with new hire training
• Works to ensure a diverse and inclusive environment
• Maintains and vets the company’s pharmacy distribution network and monitors pharmacies for effective operations
• Other duties as assigned

Qualifications

• BS/BA degree in related field AND 6+ years of pharma/biotech commercial experience, with 2+ years of experience with specialty pharmacy/market access. Specialty product experience, with CNS preferred. Previous experience in other functions in pharma/biotech desired OR
• Master’s degree or MBA preferred AND 4+ years of related experience OR
• PharmD or PhD AND 2+ years of related experience
• Strong understanding of specialty pharmacies, managed care, PBMs and government payers and their impact on product access
• Excellent working knowledge of patient support programs, including reimbursement support and financial assistance programs
• Strong understanding of the prescription adjudication process
• Ability to communicate payer coverage criteria and prior authorization processes
• Previous experience in other pharma/biotech functions (sales, management, marketing, managed markets, etc.)
• Understanding of current issues in the marketplace and national health care system
• Ability to travel overnight up to 60% (travel with field sales, attend meetings, and work with key customers)
• Roles geographically dispersed across the US
• Knowledge of best practices in the discipline and related business concepts
• Ability to improve tools and processes within the function
• Developing reputation within the company as an area of expertise
• Ability to work as part of and lead multiple teams
• Exhibits leadership and typically leads lower levels or indirect teams
• Excellent computer skills
• Excellent communication, problem-solving, analytical thinking
• Sees broader picture and impact on multiple departments/divisions
• Ability to meet multiple deadlines with accuracy and efficiency
• Excellent project management skills and ability to work in a cross-functional environment
• Excellent interpersonal skills and cross-functional team success

Skills

• Effective communication and relationship-building with HCPs, pharmacies, and internal stakeholders
• Strategic thinker with ability to influence payer policies and processes
• Problem solving and case resolution in complex coverage scenarios
• Cross-functional collaboration across sales, market access, analytics, and operations

Education

• None specified beyond the degree requirements in Qualifications

Additional Requirements

• Ability to travel overnight up to 60% (travel with field sales, attend business and industry meetings, and work with key customers)