Description
We are seeking a Patient Access Manager to serve as a point of contact for patients, caregivers, and healthcare provider office staff, providing approved information and education on oncology-specific care.
Key Responsibilities:
Patient Navigation & Support:
- Provide program-specific treatment education via approved call guides, offering the ISI and PI whenever product education is delivered.
- Educate patients on coverage outcomes, cost-sharing, and financial assistance options, including publicly available information on alternate coverage and independent foundations within program rules.
- Facilitate transfers to Specialty Pharmacy, Medical Information, the GSK Response Center, REMS vendors, and back-office Benefits Specialists for BI/BV and PA tracking when appropriate.
- Maintain accurate documentation of activities and interactions within GSK’s internal system.
- Capture and report adverse events and product quality complaints within required timeframes and follow crisis-management procedures.
Access & Reimbursement:
- Educate provider offices on payer coverage, coding, and payment policies for GSK Oncology products using approved materials and help offices understand and use GSK Patient Support Programs.
- Support access case resolution at the office level: explain benefit investigation outcomes, prior authorization requirements and processes, and appeal pathways, with the office initiating and submitting all payer forms.
- Identify access and reimbursement barriers and escalate complex, systemic, or technical payer issues to the specialist access function and to leadership.
Operational & Compliance:
- Document all interactions and manage cases in Salesforce Health Cloud / CRM in line with program standards.
- Follow all SOPs and business rules consistently, and complete training on corporate policies governing access to confidential data on time.
- Maintain strict separation between patient-facing and account-facing activity: no patient-identifiable information is shared with commercial teams, and the two sides of the role are never combined in a single engagement or documentation thread.
Basic Qualifications:
- Bachelor's degree.
- 3+ years of experience combined in any of the following areas: field reimbursement, hub case management, patient experience programs, helping patients and providers navigate insurance verification, prior authorization requirements, and access criteria.
- Ability to travel up to 20%, including overnights.
- Valid driver's license.
Preferred Qualifications:
- Extensive experience in oncology patient navigation, access and reimbursement, or hub case management.
- Advanced degree, such as an MBA, MPH, PharmD, or another relevant clinical or business degree.
- Active RN license and Bachelor of Science in Nursing (BSN).
- Experience using CRM and case-management platforms, preferably Salesforce Health Cloud, to document interactions, manage cases, and maintain accurate records.
Benefits:
- Health care and other insurance benefits (for employee and family)
- Retirement benefits
- Paid holidays
- Vacation
- Paid caregiver/parental and medical leave