Field Access Lead: Payer & Patient Support

Sky Mavis; San Diego (CA); On-site; USD 120,000 - 180,000; Full time

Job summary

EVERSANA seeks a Field Access Manager (FAM) to serve as the primary contact at designated accounts educating Healthcare Professionals and staff on the Patient Services program and payer landscape. You will coordinate access activities and support for patients prescribed our therapies.

The role requires cross-functional collaboration with Sales, Market Access, Patient Services, and external partners to remove access barriers, optimize prior authorizations, and drive timely therapy initiation.

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 for 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 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.

Responsibilities

• Expand advocacy within HCP offices and equip the staff, through education, to navigate the access and payer approval process, identify access barriers that the HCP must act on to overcome, and highlight HCP actions that support patient access to therapy.
• 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. The FAM will help identify and address time sensitive market development and implementation efforts to remove access barriers to the product for appropriate patients, while optimizing adherence.
• Build and execute a strategic business plan to meet the needs of top accounts and ensure successful implementation of market access initiatives.
• Obtain and maintain knowledge and understanding of payer landscape, including specialty pharmacy and utilization management criteria, on a national, regional and local level so that you can act as a process and payer expert.
• Continuously strive to understand the alignment of Payer/PBM/SP and how national/regional pharmacy drug formularies impact market access in their designated geography.
• Assist in providing appropriate field insights to ensure support of all access and patient/payer support programs and resources offered by the company’s Patient Support Programs.
• Anticipate, navigate and address individual account and patient access issues that arise by partnering with all appropriate stakeholders.
• Demonstrate a commitment to diversity, equity, and inclusion through continuous development, modeling inclusive behaviors, and proactively managing bias.
• All other duties as assigned.

Skills

Payer policy

Patient access

Benefit verifications

Prior authorization

Analytical skills

Cross-functional collaboration

Microsoft Teams

Educational presentations

Education

Bachelor's degree

Healthcare degree (MS, RN, PA, PharmD, or similar)

Tools

Veeva systems

Microsoft Teams

Job description

EVERSANA seeks a Field Access Manager (FAM) to serve as the primary contact at designated accounts educating Healthcare Professionals and staff on the Patient Services program and payer landscape. You will coordinate access activities and support for patients prescribed our therapies.

The role requires cross-functional collaboration with Sales, Market Access, Patient Services, and external partners to remove access barriers, optimize prior authorizations, and drive timely therapy initiation.