Patient Assistance Manager

California Specialty Pharmacy,LLC•Birmingham, AL

About The Position

The Patient Assistance Program (PAP) Manager is responsible for leading the organization's patient assistance and financial advocacy program. This role oversees the identification, coordination, and management of various financial assistance programs to help eligible patients access prescribed therapies. The manager ensures compliance with company policies, maximizes available funding, and provides leadership to the Patient Assistance team, all while promoting an exceptional patient experience. A key aspect of this role involves understanding third-party billing requirements and collaborating with multiple internal teams to ensure seamless patient access to therapy.

Requirements

Bachelors of Science degree or 10 years of related work experience
5+ years with patient financial assistance, reimbursement, specialty pharmacy, healthcare, revenue cycle, or related healthcare setting
Knowledge of basic accounting principles
Knowledge of data mining software and producing reports
Strong knowledge of manufacturer patient assistance programs, copay assistance programs, charitable foundations, Medicare, Medicaid, and commercial reimbursement.
Excellent communication, organizational, analytical, and problem-solving skills.
Experience and competency with healthcare software systems, and Microsoft office software
Ability to handle stress and meet deadlines
Complete understanding of confidentiality with respect to company proprietary information as well as information concerning patient/client care; complying with all federal and state laws as they apply to confidentiality of protected health information (PHI), and electronic protected health information (EPHI).
Follow HIPAA guidelines regarding readily identifiable protected health information.

Nice To Haves

Previous leadership or supervisory experience preferred.
3+ years of AIC, AIS, and home infusion experience is preferred.

Responsibilities

Oversees the identification, coordination, and management of manufacturer-sponsored assistance programs, charitable foundations, copay assistance, and other financial resources that help eligible patients access prescribed therapies.
Ensures full compliance with all company policies and procedures within the department with regard to Patient Assistance, Financial Hardship, and Patient Payment Policies.
Ensures timely enrollment, compliance with program requirements, and maximization of available funding opportunities.
Provides leadership to the Patient Assistance team while promoting an exceptional patient experience.
Maintains a full understanding of third-party billing requirements regarding services covered, billing look-back periods, and program requirements.
Leads, mentors, and develops the patient assistance team to ensure high-quality service and achievement of departmental goals.
Collaborates with Intake, Pharmacy, Clinical, Billing, and Revenue Cycle teams to coordinate patient access to therapy and minimize delays in treatments.
Develops and maintains departmental policies, standard operating procedures, and workflows related to patient assistance activities.
Collaborates with team members on any issues regarding billing and collections, identifies root causes, and provides resolution.
Monitors key performance indicators (KPIs) including approval rates, turnaround times, funding obtained, and patient outcomes.
Stays current on changes to manufacturer assistance programs, charitable foundation eligibility requirements, and industry regulations, and updates leadership on material changes.
Identifies opportunities for process improvement to enhance efficiency, patient satisfaction, and financial outcomes.
Utilizes data to drive positive results in billing and collection productivity with copay programs, foundations, and government programs.
Participates in meetings in connection with patient assistance intake, billing, and collection.
Ensures compliance with manufacturer guidelines, foundation requirements, HIPAA regulations, and organizational policies.
Gives high priority to client satisfaction and customer needs.
Performs other duties as assigned.