Field Access Navigator

2 days ago

Rockville, Maryland, United States Aurinia Full time
Job Title: Field Access Navigator

Aurinia is seeking a highly skilled Field Access Navigator to play a critical role in minimizing payer obstacles and optimizing access to our products for patients and healthcare providers.

Job Summary:

The Field Access Navigator will work closely with prescribing healthcare providers and their office staff, as well as nurse case managers and specialty pharmacy liaisons, to resolve access issues and facilitate resolution of complex patient access challenges.

Key Responsibilities:
  • Provide personalized access issue resolution as the patient services payer subject matter expert to support the healthcare provider segment.
  • Work with cross-functional teams to build strategic patient access and reimbursement plans for prior authorization of Aurinia's products.
  • Coordinate case escalation to Corporate Account Directors as needed.
  • Collaborate with specialty pharmacy and HUB staff to resolve denial or appeals.
  • Stay up-to-date on knowledge of the payer landscape relevant to Aurinia products to educate healthcare providers and their office staff on national, regional, and local coverage policies and processes.
  • Serve as the conduit between cross-functional field-facing teams and other Aurinia functions for all public and private payer policies and practices that impact patient access to Aurinia products.
  • Proactively communicate and explain Aurinia-specific reimbursement programs, policies, procedures, and resources to healthcare provider office staff.
  • Anticipate, navigate, and address individual account and patient access issues by partnering with all appropriate stakeholders.
  • Assist in providing field insights throughout the development of patient services marketing support materials as needed.
  • Understand Anti-bribery & Corruption (ABAC) requirements to ensure laws and regulations of the pharmaceutical industry and Aurinia policies are being followed.
  • Stay abreast of healthcare industry trends and identify patterns or connections between situations and communicate possible future challenges.
Requirements:
  • Strategic and operational reimbursement experience and familiarity with office practice policies and procedures.
  • Strong cross-functional communication mindset, solutions-oriented, and strong verbal and written communication skills.
  • Produces results, able to adapt to changing priorities, and requires minimal supervision.
  • Bachelor's Degree required.
  • Eight or more years of related experience in bio-pharma.
  • Preferred experience in market access, insurance reimbursement, large healthcare practice reimbursement, or billing experience including Medicare/Medicaid programs with a focus on specialty drug products.
  • A minimum of two or more years of demonstrated excellence and working knowledge of reimbursement support and resolution directly with healthcare provider office staff.
  • Demonstrated ability to apply reimbursement knowledge to address and resolve patient access barriers.
  • Previous experience with both private and public payers is strongly preferred.
  • Previous experience in other functions within the pharmaceutical/biotech industry is a plus, e.g., product marketing, managed care, field sales, case management, or large healthcare practice experience.
  • Proven track record of consistently meeting or exceeding goals and objectives.
  • Knowledge of CMS policies and processes with expertise in Part D (Pharmacy Benefit design and coverage policy).
  • Knowledge of commercial insurers, managed care, government, and federal payer sectors.
  • Knowledge of integrated delivery network/integrated health systems.
  • Previous experience in creating, implementing, and completing attainable business plans.
  • Understanding of national laws regarding reimbursement and regulations that impact the Field Access Navigator role.
  • Frequent travel is required to manage the assigned territory, sometimes without much notice.

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