Results-driven Associate with over 8 years of experience in pharmaceutical program management, including expertise in gastro intestinal, bone health, oncology, rare disease, and antibiotic fields. Proven track record of success in developing and managing patient-focused, high-performance programs that meet and exceed goals. Possesses extensive knowledge of payer trends, reimbursement, and patient assistance programs, with over 11 years of experience in these areas. Skilled in collaborating with cross-functional teams and external stakeholders to drive program success and improve patient outcomes. Knowledge and experience in Medicare, Medicaid, and private payer policies, reimbursement processes, health policy, coverage, payment, coding, and Specialty Pharmacy processes.
Overview
9
9
years of professional experience
Work History
Associate Director Patient Access Mana
Occam Health Services
05.2024 - Current
Developed and execute a strategic vision for assigned Patient Access Managers (PAM) aligning it with the peer teams and organization's overall goals and objectives.
Provided strong leadership and guidance to the PAMs, including setting clear performance expectations, fostering a positive work culture, and promoting professional growth and development.
Stayed updated on changes in reimbursement policies, regulations, and guidelines that may impact the AMs' work and develop strategies to adapt and respond accordingly.
Analyzed and interpret reimbursement data and metrics to identify and present trends, opportunities, challenges, and action plans to leadership centered around optimizing reimbursement access outcomes.
Drove continuous improvement initiatives to enhance the efficiency and effectiveness of reimbursement processes and workflows, leveraging technology and automation where appropriate.
Acted as a key liaison between the PAM team and senior management, providing regular updates on team performance, challenges, and strategic recommendations.
Ensured compliance with relevant laws, regulations, and industry guidelines in all reimbursement activities, including documentation, reporting, and interactions with customers.
Monitored and manage the resources allocated to the PAM team, optimizing resource allocation, and driving cost-effective strategies while maintaining service quality.
Served as the primary point of contact for all PAMs to client leadership.
Patient Access Manager
Occam Health Services
12.2023 - 05.2024
Engaged with HCPs and their staff virtually using a multi-channel approach to enhance experience, utilizing approved tools, to support and address questions about product coverages and requirements needed for reimbursement.
Supported the entire reimbursement journey from patient enrollment or initiation, access determination, payer prior authorization processes to appeals/denials requirements.
Educated HCP’s and office staff on available patient assistance programs and explained the importance of their role in facilitating access to therapy for appropriate, eligible patients. This may include training on web-based provider tools.
Served as payer and pharmacy expert for defined territory/geography and proactively communicated changes to key stakeholders, both internal and external. Coordinated support with other patient service team members or clients where appropriate.
Identified market access trends from local, regional, or national payers in assigned territory/geography, and partner with internal and client teams to enable appropriate patient access and/or support patient pull-through programs.
Analyzed assigned territory utilizing Tableau, excel or other report generators to execute comprehensive territory analysis, facilitating strategic decision making and optimal management of assigned region to identify areas of focus, trends, and monitoring and measuring assigned KPIs.
Worked collaboratively to share insights into customer needs, potential barriers, and payer issues/opportunities for product access.
Provided access insights to client Zone Access Managers (ZAM) and home office functions as required.
Identify key customer insights through effective questioning, critical thinking and problem solving. Analyzed and disseminate data and information as appropriate to partners.
Program Manager
United BioSource Corporation
10.2022 - 12.2023
Led the successful transition of hub services for 7 rare disease products, ensuring timely product access to appropriate patients and aligning with brand strategy
Managed the day-to-day operations of patient support programs for multiple products, ensuring high-quality, personalized customer support that aligned with brand strategy
Developed and monitored program performance metrics, analyzing program data to effectively communicate key performance indicators across functional areas in the commercial organization
Coordinated and led cross-functional meetings to gain insights on program status, including managing an action log for each vendor, and collaborated with internal stakeholders and agency partners to develop and maintain reimbursement marketing promotional materials
Established and maintained comprehensive programs that incorporated strategic thinking, including the use of technology that recommended solutions to both patients and providers, and identified project issues, resource gaps, and escalations to facilitate resolution
Responsible for presentation program information including program health, project life cycles to both internal and external stakeholders
Identify, execute or delegate improvement of program processes by gathering information on effectiveness of the program
Collect and interpret program metrics, as applicable
Maintain program and team performance by ensuring compliance with company and project goals
Proven track record of building and maintaining strong relationships with clients, including regular communication, anticipating and addressing their needs, and delivering excellent service
Able to manage multiple client contacts across different levels of the organization while ensuring client satisfaction and retention
Program Manager
AmerisourceBergen - Lash Group
05.2016 - 10.2022
Oversaw multiple programs while maintaining compliance and adherence to timelines for both clients and company service level agreements, monitoring and communicating across multiple groups including cross-departmental, clients, and third parties
Facilitated effective communication and collaboration among cross-departmental teams, clients, and third parties to ensure program success
Developed and implemented a comprehensive program that leverages strategic thinking and innovative technologies to provide effective solutions for both patients and providers
Proactively identified project issues, resource gaps, and escalations, and determined the best allocation of resources based on project priorities to facilitate resolution
Successfully launched and maintained patient HUB/data touchpoints, including websites, mobile applications, social networks, marketing campaigns, and customer relationship management tools
Managed reimbursement programs for a variety of products, including bone health, oncology, antibiotics, and nephrology, ensuring compliance with contractual obligations and maintaining high standards of program performance
Oversaw the catalog of access and reimbursement related to patient hubs, patient data flows, and business process maps, providing valuable insights and recommendations to drive program success
Ensured program was operating according to contractual obligations by supporting the development of patient data connections
Including the program call center, patient websites, mobile apps and other support services such as copay, nurse programs and fulfillment vendors
Analyzed quality and performance reports for trends, made process improvements, and provided coaching or retraining where needed, resulting in a 12% increase in the average program quality
Education
Bachelors - Project Management
Capella University
06.2022
Skills
Bilingual (English and Spanish)
Pharmaceutical Program Management
Leading Successful Program Launches
Managing multiple CRM's
Microsoft Office Suite
Building and maintaining strong relationships with clients