Patient Access Lead, Patient Services

Patient Access Lead

Reporting to the Regional Director, we are seeking a strong candidate to help support the initial execution and ongoing success of the Patient Support Program. This individual should be the ultimate patient champion, focusing on delivering the best possible patient experience with our patient support service offerings. Playing a key role within the Global Value & Access Team, you will be instrumental in nurturing relationships with patients and providers helping to ensure patients access critical treatment in a timely manner. Level will be commensurate with successful candidate’s background and experience.

This role is based in our Lexington office. Our office-based employees follow a hybrid schedule of 4 days in the office, and 1 day remote.

Responsibilities (including, but not limited to):

Access and Enrollment:

1. Be main point of contact for patients and providers for assigned geography
2. Be responsible for the timely enrollment and documentation of patients into the Patient Support Program
3. Conduct Benefit Verifications and Prior Authorization follow-up as needed
4. Conduct patient financial assessment eligibility based on program guidelines
5. Provide responses to general inquiry calls based on information provided as part of the program materials
6. Coordinate with Specialty and free goods pharmacies to ensure that the patient has access to the required treatment
7. Coordinate with injection training partner to ensure patients are trained in a timely manner
8. Proactively monitor the patient’s file to ensure that reimbursement and financial assistance renewals are done in a timely manner
9. Receive, record, and report Adverse Events and Product Complaints required
10. Perform data-entry, answer inbound calls, make outbound calls, manage e-mail and fax, chat, SMS etc. as appropriate
11. Proactively communicate specific patient service offerings, policies, procedures, and resources so that office staff is fluent in how to use program
12. Visit customers in the field as needed to educate and/or work through reimbursement challenges
13. Responsible for keeping abreast of compliance and OIG guidance and policies regarding Patient Services and other provider support programs. Proactively communicate any changes that have impact on existing or future programs to Patient Services leadership

• Analytics & KPIs:

1. Analyze regional program data & insights to identify opportunities for enhancing Kiniksa’s patient services offering
2. Achieves brand specific patient access objectives and maintain service levels in case management based on Key Performance Indicators established at the Program level

• Cross-functional Collaboration:

1. Support appropriate coverage discussions internally to appropriate functions and externally to key customers within assigned accounts
2. Work effectively & collaboratively with a host of internal cross-functional partners, and develop and cultivate relationships with key external stakeholders, including specialty pharmacies and vendor partners
3. Partner with internal and external stakeholders to identify, anticipate, and address patient and practice reimbursement issues

Qualifications:

• Bachelor’s degree or 8 years equivalent experience in Patient Support Services required
• Product launch experience in the US. Experience in rare diseases is highly desirable
• Experience in direct interactions with top US specialty pharmacies and payers
• Experience working with a variety of internal stakeholders, including field sales, marketing, trade & distribution, and market access
• Strong interpersonal skills
• Experience navigating CRMs to support patients from enrollment through initial dispense and ongoing access
• Demonstrated strategic thinking, initiative, and creativity related to Patient Support Program processes
• In depth understanding of all relevant US legal, compliance, and regulatory requirements required
• Strong commitment to compliance and ethical standards
• Proficient with Microsoft Office suite (i.e., Word, PowerPoint, Excel, Outlook, SharePoint, etc.)
• Salary is commensurate with experience

Kiniksa is an Equal Opportunity employer and will consider you without regard to your race, color, religion, sex, sexual orientation, gender identity, transgender status, age, genetics, national origin, protected veteran status, or disability status, or any other legally protected category. We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. Please contact us to request accommodation.