Patient Advocacy Manager (PAM) – Midwest Region

 The Patient Advocacy Manager for Catalyst Pharmaceuticals is a regional, field-based position that provides reimbursement assistance and education and support for patients with LEMs disease. This customer-facing individual will work closely with the patient and their families, physician, nurses, and payers to prevent and address barriers in patient access to medicine and help ensure optimal understanding and use of Catalyst medicines.  The PAM will also be responsible for supporting local advocacy groups’ efforts to help patients by attending their educational activities and by providing educational programs and materials.   The PAM, in conjunction with their partners at Catalyst Pathways will ensure that all the parties responsible for the care of the patient are educated on the process of starting and adhering to our FDA approved therapy.  Allocation of time will be adjusted as needed to meet the needs of each patient. The Patient Advocacy Manager reports directly to the Senior Director of Patient Services.

Primary Duties:

·         Working cross-functionally to identify and lead the resolution of patient access barriers, including: insurance coverage; reimbursement; financial limitations; site of care; procurement/distribution.

·         Working directly with the following internal and external groups to resolve access issues described above: patients and/or their families and caregivers; public and private payers (local, regional, and national); specialty pharmacies and specialty distributors; patient advocacy organizations.

·         Provide expertise and education on local and regional health plan policies, coverage, processes, etc. to the internal patient services organization, the market access field team, and the field sales organization.

·         Educate patients, families, and caregivers on coverage and reimbursement as well as insurance options

·         Educate providers on PA requirements from specific payers as well as Appeals processes needed to secure commercial reimbursement

·         Provide detailed clinical education to patients and their caregivers to ensure that all stakeholders are knowledgeable about their disease and the process to procure drug, address any reimbursement issues and help them secure insurance coverage and decrease their OOP costs.  Coordinate communication among key players to ensure that the patient has the clinical support required to transition successfully to therapy.  Work closely with Catalyst Pathways personnel (case manager, Reimbursement Manager and others as necessary) to ensure that all important activities related to starting therapy (e.g., timely physician detailing, specialty pharmacy delivery) are completed. May at times be asked to establish relationships and interact/educate healthcare providers in the region as identified by product strategy and educational goals.    Accountable for internal and external cross-functional team execution.

 

•         Ability to independently identify access solutions and determine the appropriate plan for resolution.  Lead and manage a cross-functional team in the resolution.

•         Participate in regular cross-functional team meetings to coordinate or facilitate patient services activities and field activities; cross-functional team includes case managers and field sales, and may include other functions as appropriate

 

Key Skills, Abilities, and Competencies

·         Patient-Centricity:

•         Experience working directly with patients on specialty products

•         Ability to communicate with patients, caregivers, and family members about access and care coordination issues

·         Cross-Functional Leadership:

•         Ability to lead internal teams to achieve common goals; internal teams including sales, case managers, and other commercial functions

•         Ability to lead external customers to achieve access for patients; external customers include physicians, nurses, and other health care professionals; public and commercial payers; specialty pharmacies;

•         Superior organizational and time management skills

·         Technical expertise in at least two of the following areas:

•         Rare disease access or reimbursement

•         Commercial and public reimbursement

•         Payers/managed care organizations

•         Nursing

•         Specialty pharmacies

•         Billing and coding

•         Patient Services or Patient Advocacy

•         Clinical Care or Clinical Coordination of Care

·         Demonstrate high character

•         Demonstrates empathy, compassion and understanding of the confidential nature of patient information.

•         Resilience, perseverance, humility, creativity and accountability

Travel & Availability

·         Ability to travel between 60 - 85% of the time.  Preferred locations in or near Airline HUB

·         Travel expected sometimes with little notice, as dictated by the start dates and needs of the patients and provider offices.

·         Available to talk to patients, their families and insurance providers at odd hours. Dictated by the needs of the patients, provider offices and occurrences/issues through the specialty drug distribution process.

 

Complexity and Problem Solving

·         Accountable for cross-functional communication internally (case manager, reimbursement manager, Patient Services Director)  and externally among a diverse set of customers (patient and their family, physician, nurse, specialty pharmacy)

 

Education and Experience Requirements

•         Minimum of a bachelor’s degree required

•         Minimum of 3 years of prior relationship management experience

•         Minimum of 3 years of field-based experience in account management, sales or medical affairs.