Diabetes Access & Payer Strategy Lead

Eversana; Washington; On-site; USD 140,000 - 170,000; Full time

Job summary

EVERSANA is seeking a Field Access Manager (FAM) to serve as the main contact at designated accounts, educating HCP staff and coordinating patient access across HUB and specialty channels. The role emphasizes payer strategies, regional access, and collaboration with Sales, Market Access, and Patient Services to remove access barriers and ensure therapy adoption.

The ideal candidate holds a healthcare degree with 10+ years in pharma payer policy, strong analytics, and experience with CMS

Qualifications

• Bachelor’s degree required; Healthcare degree advantageous, including MS, RN, PA, PharmD, or similar advanced healthcare/scientific degree.
• 10+ years in pharmaceutical industry with experience in payer policy and patient access.
• 5+ years of experience in benefit verifications and/or prior-authorization requirements or equivalent experience in patient access.
• Knowledge of Centers of Medicare & Medicaid Services (CMS) policies and processes with experience in Medicare Parts B & D.
• Knowledge and understanding of specialty markets, HUB/reimbursement services and patient access programs.
• Strong understanding of specialty product access/reimbursement processes including Patient Support Services programs.
• Strong analytical skills to assess market dynamics, competitor activity, and continuous diabetes monitoring trends. Ability to gather and interpret data to guide regional strategy, including understanding the role of HUB and patient claims data.
• Knowledge of Integrated Delivery Network/Integrated Health Systems.
• Strong understanding of Microsoft applications and the ability to conduct virtual engagements via Microsoft Teams.
• Ability to manage multiple priorities with excellent organizational and problem-solving skills with a high level of initiative and independence.
• Proven success in working in a cross functional environment.
• Ability to conduct impactful educational presentations.
• Strong knowledge of Veeva systems.

Responsibilities

• Expand advocacy within HCP offices and equip the staff, through education, to navigate the access and payer approval process.
• Offer educational resources to support the entire patient’s journey by optimizing processes for prior authorizations/appeals/specialty pharmacy and addressing access issues.
• Coordinate utilization of the patient service platform to seamlessly support the customer and patient when office chooses the HUB or SP as their ideal path to approved therapy.
• Coordinate annual pharmacy reauthorizations at designated accounts to ensure timely reauthorization and continuation of therapy is maintained.
• Work cross functionally and collaboratively with partners in Sales, Market Access, Patient Services, Strategic Accounts and more to act as a process and payer expert.
• Build and execute a strategic business plan to meet the needs of top accounts and ensure successful implementation of market access initiatives.

Skills

Payer policy

Patient access

CMS policy knowledge

HUB/reimbursement

Cross-functional collaboration

Microsoft Teams

Analytical skills

Education

Bachelor’s degree

Healthcare degree advantageous

Tools

Veeva systems

MS Office

Job description

EVERSANA is seeking a Field Access Manager (FAM) to serve as the main contact at designated accounts, educating HCP staff and coordinating patient access across HUB and specialty channels. The role emphasizes payer strategies, regional access, and collaboration with Sales, Market Access, and Patient Services to remove access barriers and ensure therapy adoption.

The ideal candidate holds a healthcare degree with 10+ years in pharma payer policy, strong analytics, and experience with CMS