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Job Responsibility
Secure written or electronic patient HIPAA for patients in the assigned geography
Develop relationships with patients and caregivers by engaging via phone, text, email, virtual or in person connections
Assess individual needs of the patient and develop an appropriate education and resource plan of action, considering the patient’s family and team of healthcare providers to empower the patient to become their own advocate
Educate the patient on TEPEZZA coverage based on their benefits and the steps needed to gain prior authorization to ensure understanding of the process for medication access
Provide information on co-pay assistance programs, national foundations, and free drug programs by sharing information to patients as appropriate and needed
Provide proactive education to prescribers and sites of care upon patient enrollment on coverage for Horizon rare disease therapies, common prior authorization requirements, and coding and billings requirements
Provide access and reimbursement education based on the enrolled patient’s TEPEZZA benefits to physician offices and sites of care
Educate the physician office and/or SOC on TEPEZZA coverage based on the patient’s benefits and the steps needed to gain prior authorization to ensure understanding of the process for medication access
Investigate access challenges pre and post-infusion to include support for denied claims and claim reviews
Partner with Safety and PV and report AE’s and product complaints through medical information
Work closely with the Horizon cross functional team including Case Managers, the Site of Care team, market access, matrix partners and external vendors
Adhere to professional standards compliance guidance, policies and procedures, federal, state, and local requirements
Requirements
Doctorate degree and 2 years of patient services, and/or access and reimbursement, experience
OR Master's degree and 4 years of patient services, and/or access and reimbursement, experience
OR Bachelor's degree and 6 years of patient services, and/or access and reimbursement, experience
Nice to have
Scientific background and ability to learn product and disease information
Nursing or other clinical background a plus
Access and reimbursement for buy and bill products
Orphan or Rare disease experience
Familiarity with HIPAA guidelines and FDA requirements
Familiarity with and Adherence to internal and OIG Compliance guidelines a must
Ability to handle difficult patient cases and resolve hurdles
Ability to work in team environment and manage communication with case Liaisons and sales reps
Ability to respond immediately when necessary (within 24 hours) to prevent lapses in treatment
Strong analytical skills and ability to report on meaningful activity in the region
Proficient in Microsoft Office
Professional, proactive demeanor
Strong interpersonal skills and strategic mindset
Excellent written and verbal communication skills
Potential for up to 50% travel, including some overnight and weekend commitments
What we offer
Comprehensive employee benefits package, including a Retirement and Savings Plan with generous company contributions, group medical, dental and vision coverage, life and disability insurance, and flexible spending accounts
A discretionary annual bonus program, or for field sales representatives, a sales-based incentive plan
Stock-based long-term incentives
Award-winning time-off plans and bi-annual company-wide shutdowns
Flexible work models, including remote work arrangements, where possible