Position Summary:
The Patient Access Manager is a field-based single point of contact (SPOC) helping providers and patients navigate coverage, reimbursement, and support solutions so patients start and remain on therapy. The PAM is the primary contact for consented patients and caregivers across the GSK Oncology portfolio, guiding them through onboarding, access, and ongoing phases of the treatment journey, and supports provider accounts within the territory on coverage, coding, and payment questions after a prescribing decision has been made. The role is non-promotional and provides one accountable contact across the GSK Oncology portfolio.
Key Responsibilities:
Patient Navigation & Support:
- Serve as the point of contact for patients, caregivers, and HCP office staff, providing approved information and education on oncology-specific care, including benefit discussions, product and disease-state per the PI,
- and program-specific resources.
- Conduct welcome calls and ongoing journey touchpoints, speaking to the end-to-end patient experience within program specifics and using approved call guides, FAQs, and the Prescribing Information.
- Support patient enrolment in GSK services, including PAP, and guide patients and offices through enrolment requirements, missing information, and consent capture.
- Provide program-specific treatment education via approved call guides, offering the ISI and PI whenever product education is delivered.
- Educate patients on coverage outcomes, cost-sharing, and financial assistance options, including publicly available information on alternate coverage and independent foundations within program rules.
- Facilitate transfers to Specialty Pharmacy, Medical Information, the GSK Response Center, REMS vendors, and back-office Benefits Specialists for BI/BV and PA tracking when appropriate.
- Conduct all patient communication through approved recorded telephony and program systems, verifying patient identifiers and consent status before each interaction.
- Maintain accurate documentation of activities and interactions within GSK’s internal system.
- Capture and report adverse events and product quality complaints within required timeframes and follow crisis-management procedures.
- Adhere to company policies and procedures, compliance guidance, and policies applicable to federal, state, and local regulations.
- Ensures activities align with HIPAA privacy requirements and internal compliance guidelines.
Access & Reimbursement:
- Educate provider offices on payer coverage, coding, and payment policies for GSK Oncology products using approved materials and help offices understand and use GSK Patient Support Programs.
- Support access case resolution at the office level: explain benefit investigation outcomes, prior authorization requirements and processes, and appeal pathways, with the office initiating and submitting all payer forms.
- Identify access and reimbursement barriers and escalate complex, systemic, or technical payer issues to the specialist access function and to leadership.
- Interface with Payer Account Managers, Specialty Pharmacy Account Directors, and Oncology Sales teams within the boundaries of the PAN Standard and program ways of working.
Operational & Compliance:
- Document all interactions and manage cases in Salesforce Health Cloud / CRM in line with program standards.
- Follow all SOPs and business rules consistently, and complete training on corporate policies governing access to confidential data on time.
- Maintain strict separation between patient-facing and account-facing activity: no patient-identifiable information is shared with commercial teams, and the two sides of the role are never combined in a single engagement or documentation thread.
- Operate strictly within approved materials and compliance guardrails, maintaining the highest level of ethics and integrity.
Basic Qualifications:
- Bachelor's degree.
- 3+ years of experience combined in any of the following areas: field reimbursement, hub case management, patient experience programs, helping patients and providers navigate insurance verification, prior authorization requirements, and access criteria.
- Ability to travel up to 20%, including overnights.
- Valid driver's license.
Preferred Qualifications:
- Candidates should reside within the assigned territory or within 30 miles of the territory border.
- Extensive experience in oncology patient navigation, access and reimbursement, or hub case management.
- Advanced degree, such as an MBA, MPH, PharmD, or another relevant clinical or business degree.
- Active RN license and Bachelor of Science in Nursing (BSN).
- Experience using CRM and case-management platforms, preferably Salesforce Health Cloud, to document interactions, manage cases, and maintain accurate records.
- Excellent verbal, written, and presentation communication skills.
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Skills
Data to Insights, Digital Fluency, Market Access Strategies, Matrix Leadership, Payer Evidence, Pricing Strategies, Scientific Literacy
Please visit GSK US Benefits Summary to learn more about the comprehensive benefits program GSK offers US employees.
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