Patient Access Liaison

Tolmar Careers•Buffalo Grove, IL

About The Position

The Patient Access Liaison will play a key role in ensuring timely and sustained access to Tolmar products. In this highly collaborative role, you will serve as a critical liaison among healthcare providers, specialty pharmacies, hub services and internal cross-functional teams. The Patient Access Liaison plays a critical role in managing case-level communications, resolving access issues, supporting data quality, and providing market insights to senior leadership. Your knowledge of payer coverage and access processes for both pharmacy and medical benefit (buy & bill) pathways will create confidence with our providers in their ability to efficiently obtain Tolmar products.

Requirements

Excellent working knowledge of hub services, specialty pharmacies and patient support programs
Deep understanding of the patient access landscape and grasp of the patient access journey in the specialty pharmacy marketplace
Strong understanding of the U. S. Healthcare reimbursement systems and payers (Medicare, Medicaid and commercial plans) in your assigned region
Knowledge of coding and billing processes for buy & bill (J-codes, CPT, ICD-10)
Excellent communication, problem solving and analytical thinking skills
High attention to detail, diligence and reliability
Excellent case management skills and ability to work in a cross-functional environment, handling multiple tasks
Exceptional computer skills (especially Excel)
Bachelor’s degree required
5+ years of pharma/biotech experience
2+ years of experience with specialty pharmacy/market access

Nice To Haves

Experience in rare disease markets preferred
Expertise within the pharmacy benefit landscape as well as expertise with buy & bill

Responsibilities

Serve as the primary point of contact for day-to-day communications with the hub and specialty pharmacy partners, ensuring a smooth case management process and an optimal experience for patients & providers
Monitor patient case progress, reconcile data discrepancies, research case inquiries and provide updates to key stakeholders as needed
Actively manage all of your assigned cases daily ensuring that the appropriate status is applied to each case
Leverage data and insights to determine where action is required to move a case forward towards a dispense
Work independently and collaboratively with key stakeholders to resolve complex access issues, promoting positivity and teamwork
Conduct weekly 1:1 meetings with sales team to compliantly update them on their cases
Foster an environment of exceptional customer service to both internal and external customers, addressing requests and escalations accurately, promptly and compliantly
Educate providers on payer coverage criteria, forms, processes, prior authorizations, appeals, formulary exception requests and documentation requests
Identify gaps in account knowledge of the acquisition process and provide education/resources to fill those gaps to improve the account and provider experience
Create awareness with providers of the available patient support programs & services offered by Tolmar and train accounts how to appropriately utilize those resources
Provide acquisition, billing & coding support to customers utilizing the buy & bill pathway
Provide stakeholders (internal and external) with updates regarding changes to payers, pharmacies, programs and processes that impact them
Align with Market Access team regarding payer coverage updates
Ensure compliance with all relevant regulations and company policies
Responsible for reporting Adverse Events and Technical Complaints to Tolmar Pharmacovigilance and Patient Safety (PSSP) that you learn of per SOP-00821, Pharmacovigilance and Technical Complaint Reporting

Benefits

Tolmar compensation programs are focused on equitable, fair pay practices, including market-based base pay and a strong benefits package.
Competitive and inclusive medical, dental, and vision coverage options
Flexible Spending Accounts for medical expenses and dependent care expenses
HSA through our HDHP CompleteCare reimburses you and your dependents for eligible health care expenses and premium expenses incurred under alternate group health coverage
Generous 401K match - currently match 100% of your contributions up to the first 6% of compensation and 50% from 7%-12%, but never greater than 9%
Tolmar-paid Life, LTD, and STD insurance coverages, as well as voluntary benefit options
Employee Assistance Plan, Legal Guidance, and Funeral Planning & Concierge Services
Adoption and family-planning benefits, Fertility and Family Forming Benefits
Generous paid time off, including: Vacation, sick time, and holidays
Volunteer time to participate in your community
Discretionary year-end shutdown