Patient Access Manager

Position Summary

The Patient Access Manager serves as the primary point of contact for patients, compliantly guiding them through the medication coverage and reimbursement process to foster timely, affordable therapy access while delivering a supportive and personalized experience.

Key Responsibilities

• Act as the main point of contact for patients and caregivers, offering education, guidance, and ongoing support throughout the access and reimbursement journey.
• Lead the case management process with urgency and accountability to achieve prompt and compliant access to therapy.
• Conduct benefit investigations, verify coverage, and facilitate prior authorization, denial, and appeal processes.
• Facilitate enrollment in financial assistance programs and coordinate with patients, payers, and partners to maintain continuity of care.
• Collaborate with healthcare offices, specialty pharmacies, payers, and internal partners to resolve complex reimbursement or fulfillment challenges.
• Maintain expertise in payer policies, reimbursement pathways, and product distribution channels to anticipate and address access barriers.
• Communicate clearly, compliantly, and compassionately with patients, families, and HCP offices about case progress and available support.
• Accurately document all case activity in real time within CRM systems to ensure data quality and case continuity.
• Share insights, identify trends, and contribute to process and quality improvement initiatives.
• Demonstrate professionalism, empathy, and proactive problem-solving in all interactions while adhering to company policies, privacy standards, and regulations.

Qualifications

• Education: Bachelor’s degree preferred; advanced degree (MSW, MHA, MBA) preferred.
• Experience: 7+ years in healthcare or pharmaceutical industry, and 5 years of patient access, reimbursement, case management, direct patient-facing high-touch experience required.
• Skills: Deep understanding of health insurance benefits, payer policies, and reimbursement processes; proven ability to coordinate across healthcare stakeholders, including providers, specialty pharmacies, and financial assistance programs; skilled in resolving complex access issues such as benefit verification, prior authorization, and appeals; excellent communication, empathy, and critical thinking skills; strong organizational and documentation abilities with sharp attention to detail; effective collaborator within a matrixed environment.
• Up to 15% domestic travel may be required.
• Preferred: Bilingual in Spanish (written and spoken fluency); experience in pharmaceutical or biotech patient services; familiarity with multiple drug distribution channels; proficiency in Salesforce CRM.