Lead, Patient Access

Purpose

The Patient Access Specialist Lead (PAS) provides support to supervisors and management through daily workload management, creating daily staffing strategies and providing case escalation support. Ensure that all day to day activities of the team operate smoothly and seamlessly as per established KPIs while assuring the PAS Team provides high level customer services to our patients and health care providers (HCPs).

Responsibilities

• Subject matter expert in all aspects of the Patient Access Specialist role including patient and HCP communication, insurance investigation, payer calls, and conduct financial assessments to render the appropriate decision of approval or denial into the program
• Maintains and updates team documents and process updates
• Makes sure all day-to-day activities of the team operate smoothly and efficiently, adjusting workload and staffing requirements as needed to meet KPIs and quality goals
• Monitors and assigns work, ensuring all cases are addressed in a timely and efficient manner
• Provides activity metrics, status updates, and program intelligence to management as needed to ensure program success and compliance
• Handles escalated patient cases and communicates with management or the Abbvie Patient Assistance Foundation as necessary
• Collaborates with direct staff and cross-functionally within the PAP team to resolve patient issues and concerns
• Aids management in developing and adhering to functional area policies, procedures, and work instructions to achieve compliance in a dynamic, quickly changing environment
• Ensures all patient cases are documented in the Customer Relationship Management System (CRM) in accordance with all business rules and policies
• Assists on special projects within job scope to improve processes when requested by management

Qualifications

• High school diploma or equivalent required. College or a 2-year Associate Degree is preferred
• A minimum of 3-5 years experience within a healthcare provider, PBM, Specialty Pharmacy or Retail/MailOrder Pharmacy setting, strong core insurance (Medical and Pharmacy Benefit) knowledge
• Knowledge of online verification systems or similar experience required
• Previous leadership in a call center, integrated health care provider, managed care, or healthcare insurance setting desired
• Strong understanding of health care reimbursement channels including; commercial pharmacy, major medical and governmental programs
• High quality customer service and strong analytical skills
• Ability to operate under general supervision
• Ability to express ideas clearly in both written and oral communications
• Strong attention to detail and with the ability to multi-task required

Additional Information

Applicable only to applicants applying to a position in any location with pay disclosure requirements under state or local law: The compensation range described below is the range of possible base pay compensation that the Company believes in good faith it will pay for this role at the time of this posting based on the job grade for this position. Individual compensation paid within this range will depend on many factors including geographic location, and we may ultimately pay more or less than the posted range. This range may be modified in the future.

We offer a comprehensive package of benefits including paid time off (vacation, holidays, sick), medical/dental/vision insurance and 401(k) to eligible employees. This job is eligible to participate in our short-term incentive programs.

Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, incentive, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole and absolute discretion unless and until paid and may be modified at the Company's sole and absolute discretion, consistent with applicable law.

AbbVie is an equal opportunity employer and is committed to operating with integrity, driving innovation, transforming lives and serving our community. Equal Opportunity Employer/Veterans/Disabled.

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