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Healthcare Access Advocate

2 months ago

Rockville, Maryland, United States Aurinia Pharmaceuticals Full time


Our Mission: Transforming the future of autoimmune disease management.
Our Vision: Empowering patients to achieve their best health.

At Aurinia Pharmaceuticals, we are a passionate team dedicated to revolutionizing the treatment landscape for autoimmune diseases that currently lack effective solutions. Our commitment to delivering innovative medical therapies drives us forward. We are tenacious. We are compassionate.

In addition to promoting our approved therapy, LUPKYNISTM, for eligible patients with lupus nephritis, we are actively expanding our portfolio of groundbreaking treatments for autoimmune conditions.

Our approach harnesses the expertise of our skilled team and our extensive experience in ethical drug development and market introduction. At Aurinia, we foster an environment where every individual can excel, guided by our Cultural Values:
  • Collaborate for success
  • Work together
  • Innovate and develop
  • Act with integrity
Together, we strive to alter the course of autoimmune diseases for those in need.

Position Overview
Aurinia is currently in search of a Field Access Navigator (FAN). The FAN is crucial in alleviating payer barriers and enhancing access to Aurinia products for patients and healthcare providers (HCPs). Within a cohesive, cross-functional operational framework, the FAN is tasked with addressing access challenges by strategically collaborating with HCPs and their administrative teams to resolve issues related to prior authorizations, denials, and appeals, as well as tackling complex patient access hurdles. The FAN will work closely with prescribing HCPs and their support staff, nurse case managers, and Specialty Pharmacy liaisons on any access issues that require escalation. Additionally, the FAN will facilitate the resolution of HCP challenges by engaging relevant Aurinia cross-functional team members. The FAN will devise a patient-focused reimbursement strategy and proactively communicate payer criteria, terms, and practices concerning reimbursement for the designated Aurinia products.

Key Responsibilities:
  • Deliver personalized, face-to-face access issue resolution as the Patient Services payer expert, supporting the healthcare provider segment.
  • Collaborate with cross-functional teams to develop strategic patient access and reimbursement plans for prior authorization of Aurinia's products.
  • Coordinate case escalations to the appropriate Corporate Account Directors.
  • Work with Specialty Pharmacy and HUB personnel to address any denials or appeals.
  • Maintain expertise on the payer landscape relevant to Aurinia products to educate HCPs and their staff on coverage policies and processes.
  • Act as a liaison between cross-functional field teams and other Aurinia departments regarding public and private payer policies that affect patient access to Aurinia products.
  • Proactively communicate and clarify Aurinia-specific reimbursement programs, policies, and resources to ensure HCP office staff are well-informed on utilizing Access Programs for Aurinia products.
  • Anticipate, navigate, and resolve individual account and patient access issues by collaborating with all relevant stakeholders.
  • Assist in providing field insights during the development of Patient Services marketing support materials as necessary.
  • Understand Anti-bribery & Corruption (ABAC) requirements to ensure compliance with pharmaceutical industry laws and Aurinia Policies.
  • Stay informed about healthcare industry trends and identify potential challenges.
  • The FAN may be assigned to additional products as Aurinia expands its offerings.
Qualifications:

The ideal candidate will possess strategic and operational reimbursement experience, along with familiarity with office practice policies and procedures. A strong cross-functional communication approach, solutions-oriented mindset, and excellent verbal and written communication skills are essential. The candidate should demonstrate a track record of producing results, adapting to changing priorities in a dynamic environment, and requiring minimal supervision.
  • Bachelor's Degree required.
  • Eight or more years of relevant experience in the biopharmaceutical sector, preferably in market access, insurance reimbursement, or billing, including Medicare/Medicaid programs focused on specialty drug products.
  • A minimum of two years of proven expertise in reimbursement support and resolution directly with HCP office staff.
  • Demonstrated ability to apply reimbursement knowledge to overcome patient access barriers.
  • Prior experience with both private and public payers is strongly preferred.
  • Experience in other pharmaceutical/biotech functions, such as product marketing, managed care, field sales, or case management, is advantageous.
  • Proven history of consistently meeting or exceeding goals and objectives.
  • Knowledge of CMS policies and processes, particularly regarding Part D (Pharmacy Benefit design and coverage policy).
  • Familiarity with Commercial Insurers, Managed Care, Government, and Federal payer sectors.
  • Understanding of Integrated Delivery Networks/Integrated Health Systems.
  • Experience in creating, implementing, and executing achievable business plans.
  • Knowledge of national reimbursement laws and regulations impacting the FAN role.
  • Frequent travel may be required to manage the assigned territory, sometimes with little notice.
Additional Information
All candidate information will be kept confidential according to EEO guidelines.