Patient Access Manager I, Access Specialist - West

Overview

The Patient Access Manager I (PAM I) is a critical, highly visible role responsible for collaborating with internal and external stakeholders to ensure efficient, and compliant operations and communications in an effort to provide patients with access to Xeris’ prescribed therapies.  Working with insurers, specialty pharmacies, and HCPs, the PAM I demonstrates superior knowledge of insurer’s prior authorization processes to identify and resolve issues impacting treatment initiation and ongoing therapy. The Patient Access Manager I, is accountable for providing exceptional service at all touch points and must anticipate and address challenges while understanding the time-sensitivity of each situation. This role will develop and maintain relationships with Sales and other members of the Patient Access team supporting therapy initiation and adherence.

Responsibilities

• Develop action plans that provide for the initiation and continuation of treatment with Xeris products and services.
• Work within pre-determined processes to facilitate the conversion of referrals to prescriptions for Xeris marketed products in full compliance with relevant regulations and policies.
• Develop a comprehensive understanding of the reimbursement process, insurance plans, payer trends, patient assistance programs, and related patient resources.
• Demonstrate awareness of HIPAA and other laws and regulations to ensure actions are compliant.
• Develop and foster highly collaborative and productive working relationships with internal and external stakeholders.
• Assist in obtaining insurance approval for Xeris’ therapies, and proactively plan for maintenance of coverage by working with specialty pharmacy, payers, and Xeris colleagues.
• Troubleshoot cases while interfacing with key stakeholders (internal/external) to ensure optimal start to therapy.
• Understand the resources available in their specific geography and how they can be best deployed to support patient care.
• Maintain disease, reimbursement, and insurance coverage expertise through continuing education and attendance at relevant conferences and other educational opportunities.
• Foster collaborative relationships with all internal and external customers including butnot limited to Patient Access Managers, Medical, Sales, National Accounts, Patient Advocacy, specialty pharmacy, and HCPs.
• Maintains accurate data on every case, coverage approvals, on-going coverage requirements and all patient and provider interactions.
• Ensures compliance with all corporate and industry policies in collaboration with Xeris Legal and Compliance.

Qualifications

• Bachelor’s Degree in Health Sciences, Business/Marketing, Nursing or related field; Advanced degree preferred or equivalent combination of education, training, and experience.
• Minimum of 3 years of business experience in the healthcare or biotech industry. Ultra-rare disease experience a plus.
• Experience should include insurance reimbursement, prior authorization and appeals, patient assistance programs, and billing and coding.
• Knowledge of Commercial payers, Medicare, and Medicaid reimbursement processes required.
• Experience administering self-insured medical plans in a corporate environment, liaising between participants and insurance carriers and assisting in the prior-authorization process is a plus.
• Ability to navigate difficult conversations and handle sensitive issues with opposing opinions.
• Competencies: Customer Service focus, Teamwork & Collaboration, Attention to Detail, Self-Starter, Problem Solving, Organizational skills, Adaptability, Professionalism, Written and Verbal Communications,
• Working Conditions: Position may require periodic evening and weekend work, as necessary to fulfill obligations. Frequent travel up to 20% domestically. Must be able to support regional geographies and time zones.

#LI-REMOTE

As an equal employment opportunity and affirmative action employer, Xeris Pharmaceuticals, Inc. does not discriminate on the basis of race, color, religion, sex, gender identity, sexual orientation, national origin, age, disability, veteran status, genetics or any other characteristic protected by law.  It is our intention that all qualified applications are given equal opportunity and that selection decisions be based on job-related factors.

The anticipated base salary range for this position is $105,000 to $125,000. Final determination of base salary offered will depend on several factors relevant to the position, including but not limited to candidate skills, experience, education, market location, and business need. This role will include eligibility for bonus and equity. The total compensation package will also include additional elements such as multiple paid time off benefits, various health insurance options, retirement benefits and more. Details about these and other offerings will be provided at the time a conditional offer of employment is made. Candidates are always welcome to inquire about our compensation and benefits package during the interview process.  

NOTE:  This job description is not intended to be all-inclusive. Employee may perform other related duties as negotiated to meet the ongoing needs of the organization.