Diabetes Field Access & Payer Lead

Sky Mavis; Miami (FL); On-site; USD 120,000 - 180,000; Full time

Job summary

EVERSANA is seeking a Field Access Manager (FAM) to serve as the primary contact at designated accounts, educating HCP staff on access pathways, payer requirements, and the Patient Services program. You will coordinate HUB/sp paths, optimize prior authorizations, and partner with Sales, Market Access, and Patient Services to remove access barriers while ensuring timely therapy continuation.

The role requires deep payer policy knowledge, extensive experience in patient access, and strong

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 CMS policies and processes with experience in Medicare Parts B & D.
• Knowledge 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 diabetes monitoring trends; ability to interpret data for regional strategy.
• Knowledge of IDN/Integrated Health Systems.
• Strong understanding of Microsoft applications and virtual engagements via Teams.
• Ability to manage multiple priorities with strong organizational and problem-solving skills.

Responsibilities

• Expand advocacy within HCP offices and educate staff to navigate access and payer approval processes.
• Offer educational resources to support the patient journey by optimizing prior authorizations and appeals.
• Coordinate use of patient service platform to support the customer and patient when HUB or SP is chosen.
• Coordinate annual pharmacy reauthorizations at designated accounts to ensure timely continuation of therapy.
• Work cross-functionally with Sales, Market Access, Patient Services, and Strategic Accounts to remove access barriers.
• Build and execute a strategic business plan to meet the needs of top accounts and implement market access initiatives.
• Know payer landscape including specialty pharmacy and utilization management at national, regional, and local levels.
• Understand alignment of Payer/PBM/SP and formularies across geography.
• Provide field insights to support access and patient/payer programs.
• Anticipate and address account/patient access issues with stakeholders.
• Demonstrate commitment to diversity, equity, and inclusion in actions and bias management.
• All other duties as assigned.

Skills

Payer policy

Patient access

CMS policies

HUB/reimbursement

Data analysis

Cross-functional collaboration

Microsoft Teams

Organizational skills

Problem solving

Education

Bachelor's degree

Healthcare degree advantageous (MS/RN/PA/PharmD)

Tools

Veeva systems

Microsoft Teams

Job description

EVERSANA is seeking a Field Access Manager (FAM) to serve as the primary contact at designated accounts, educating HCP staff on access pathways, payer requirements, and the Patient Services program. You will coordinate HUB/sp paths, optimize prior authorizations, and partner with Sales, Market Access, and Patient Services to remove access barriers while ensuring timely therapy continuation.

The role requires deep payer policy knowledge, extensive experience in patient access, and strong