Patient Access Case Manager

The Company:
It’s not often you get the chance to make a real impact on the lives of others, while expanding your own possibilities. You’ll find that rare opportunity at PharmaEssentia. Join us, and let’s transform lives, together.
PharmaEssentia Corporation is a rapidly growing biopharmaceutical innovator. We are leveraging deep expertise and proven scientific principles to deliver effective new biologics for challenging diseases in the areas of hematology and oncology, with one approved product and a diversifying pipeline. We believe in the potential to improve both health and quality of life for patients with limited options today through the combination of rigorous research and innovative thinking.
Founded in 2003 by a team of Taiwanese-American executives and renowned scientists from U.S. biotechnology and pharmaceutical companies, today we are listed on the Taiwan Stock Exchange (TWSE: 6446) and are expanding our global presence with operations in the U.S., Japan, China and Korea, along with a world-class biologics production facility in Taichung. 

Position Overview:
The Patient Access Case Manager will be the primary resource to patients enrolled in SOURCE (PharmaEssentia’s dedicated patient support program). This role is responsible for conducting personalized patient outreach and providing guided support throughout the patient access journey. This role will identify patient barriers to treatment, provide education, and work to resolve access barriers on a case-by-case basis. This role interacts and collaborates with internal and external stakeholders to prevent and address non-clinical barriers to access. This individual is a strategic, passionate, self-starter who takes initiative to support a best-in-class patient and customer experience.

This is a hybrid role with an in-office requirement at our Burlington, MA office location.

Key Responsibilities:

• Lead the case management process, while balancing the needs of individual patients and aligning with department goals and objectives.
• Act as primary patient support contact to ensure a seamless and personalized patient experience.
• Engage patients/families to create a trusting relationship, uncover patient needs, and understand access challenges.
• Educate patients/caregivers and other care team members about SOURCE, insurance requirements or limitations, assistance programs, disease specific organizations and relevant disease/product information as necessary to support access. 
• Consistently identify complex, patient-specific issues, provide relevant education and resources to patients, and initiate an action plan to eliminate any access barriers.
• Empower patients through education to self-identify potential barriers and participate in action plans that support their treatment journey.
• Engage patients at critical points in patient journey to provide additional support and resources, until identified access barriers are eliminated.
• When eligible, educate and enroll patients in assistance programs available through SOURCE.  Monitor to ensure continued eligibility.
• Leverage data and reporting tools to manage caseload and prioritize patient needs.
• Consistently maintain accurate data, including case updates and next steps, new insurance information or coverage approvals, for all patient cases and interactions.
• Establish and maintain professional and effective relationships with all internal and external stakeholders including but not limited to HUB, specialty pharmacies, and market access colleagues.
• Work collaboratively with all access stakeholders to ensure all available resources have been activated to address access barriers.
• Coordinate communication between Patient Access Leadership, Field Access Managers, Case Managers, and Specialty Pharmacy partners and notify of case updates that require their action via identified process.
• Demonstrate and maintain an understanding of HUB and program business rules, patient journey and HUB communication documents for patients and HCPs.
• Represent SOURCE and serve as a subject matter expert at external meetings and conferences on an as needed basis.
• Demonstrate and maintain an understanding of the role for all market access colleagues, patient access goals, and patient support services at HUB and specialty pharmacy.
• Drive innovation by consistently monitoring systems, processes, and potential gaps and offering new ideas and solutions to elevate the patient support program.
• Maintain a comprehensive understanding of navigation of health care systems, pharmacy and medical coverage, insurance plan types & payer trends.
• Effectively identify and share new trends or other knowledge that could negatively impact BESREMi access with the Patient Access leadership team.
• Provide caseload coverage outside of assigned territory as needed.
• Comply with laws, regulations and rules governing the pharmaceutical industry.

Qualifications and Experience: 

• Bachelor’s degree required.
• Minimum 3-5 years of experience in a patient-facing or case management role.
• In-depth understanding of health insurance benefits, relevant state and federal laws and insurance regulations.
• Proficiency in billing/coding, insurance plan types, medical and pharmacy benefits, and relevant state and federal laws and insurance regulations.
• Proven ability to collaborate with internal and external stakeholders.
• Excellent attention to detail, organizational skills, and ability to multi-task and deliver results in a fast-paced environment.
• Strong analytical capabilities to ensure robust inputs to decision-making.
• Strong interpersonal skills including the ability to listen actively and synthesize information in a meaningful way.
• Excellent communication (verbal and written) skills with proven ability to present to large and small audiences.
• Ability to appropriately represent the patient access team in all internal and external settings.
• Good judgment, and an ability to adapt and change in a shifting environment.
• Willingness to travel up to ~10% domestically.

Preferred Qualifications and Experience: 

• Degree in health care, social work, or human services field.
• Experience with financial assistance programs, charitable access, or patient access programs.
• Prior experience working with oncology, rare, or chronic disease patient communities.
• Biotech/pharma patient services experience.
• Bi-lingual skills (Spanish-speaking).

Benefits of working with our team:
PharmaEssentia USA strives every day to improve the lives of patients as well as our employees. As a valued member of PharmaEssentia USA, you will enjoy the following benefits:

• Comprehensive medical coverage
• Dental and vision coverage
• Generous paid time-off
• 401(k) retirement plan with competitive company match
• Medical & Dependent Care Flexible Spending Account
• Up to $150 monthly cell phone reimbursement
• Employee Assistance Program
• Free parking

At PharmaEssentia USA, we are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants without regard to race, color, religion, sex, pregnancy (including childbirth and related medical conditions), national origin, age, physical and mental disability, marital status, sexual orientation, gender identity, gender expression, genetic information (including characteristics and testing), military and veteran status, and any other characteristic protected by applicable law. PharmaEssentia USA believes that diversity and inclusion among our team are critical to our success as a global company, and we seek to recruit, develop and retain the most talented people from a diverse candidate pool.  PharmaEssentia does not accept unsolicited agency resumes. Staffing agencies should not send resumes to our HR team or to any PharmaEssentia employees. PharmaEssentia is not responsible for any fees related to unsolicited resumes from staffing agencies.

It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.

At PharmaEssentia, our goal is to treat as many people with cancer as possible. That means challenging the status quo with better science that leads to better lives. By joining our team, you will not only expand your own possibilities, but you will contribute to expanding options for people with cancer.

https://us.pharmaessentia.com/careers/