Industry: Ophthalmic Medical Technology and Pharmaceutical Company

Why consider this job opportunity:

- Competitive salary (based on experience)
- Bonus eligibility
- Medical/dental/vision benefits
- Life insurance
- Stock options
- 401(k) Employer Match
- Employee Stock Purchase Program
- Generous time off & paid holidays
- Time-off to volunteer in the community
- Opportunity to work for a company pioneering a new glaucoma treatment class
- Glaukos Corporation has been Certified as a Great Place to Work the last two years

What to Expect (Job Responsibilities):

- Represents a consistent "Patient First" approach to the business activities and relationships
- Collaborates with Reimbursement Liaisons and Case Managers to identify and eliminate barriers to access for patients enrolled in GPS
- Manages all forms of communication in a timely and professional fashion to ensure patient needs are fully met and all relevant internal stakeholders are appropriately updated
- Provides education on navigating the appeals process, denied and partially paid claims, and specialty pharmacy and buy & bill acquisition options
- Monitors reimbursement trends and policy changes, claim denials, underpayments, etc. and engages Reimbursement Liaisons appropriately when patient access may be jeopardized
- Interprets benefit verifications including PA requirements, calculation of patient cost share, and drug acquisition options for specific patients enrolled in GPS
- Responds to questions related to coding, payer policy, and approval protocols
- Offers expertise on navigating copay assistance for appropriate patients enrolled in GPS
- Ability to travel, as well as overnight travel (~20%) and attendance at scheduled training and meetings

What is Required (Qualifications):

- Bachelor's degree required
- 3+ years' experience working in Patient Services and/or patient access programs, reimbursement or sales experience with physician-administered injectables and/or medical devices, Category III CPT codes and/or miscellaneous J-codes, specialty pharmacy and buy & bill acquisition, and benefit verifications, prior authorizations, claims assistance, and appeals
- 5+ years sales, district management, marketing, field reimbursement, patient advocacy or patient access manager experience
- Payer/insurance coverage experience with Medicare, Medicare Advantage, VA/Tri-Care, Commercial and Medicaid plans
- Significant experience working with a Patient Service Center/Hub
- Successful navigation of complex authorization processes for specialty medications, Orphan, or Rare disease
- Educated Healthcare Professionals or patients on the availability of patient support programs such as Co-Pay Assistance and Patient Assistance Programs

How to Stand Out (Preferred Qualifications):

- Advanced degree preferred
- Clinical Nurse or Medical Billing & Coding certification a plus
- 2+ years Eyecare experience preferred

#ophthalmicmedicaltechnology #pharmaceutical #patientsupport #reimbursementliaison #patientaccess #healthcare

We prioritize respecting candidate privacy and championing equal-opportunity employment. Central to our mission is partnering only with companies that echo this commitment. We strive to foster a fair, transparent, and secure hiring environment for all. Should you encounter any employer not adhering to these principles, please bring it to our attention immediately.

Talentify isn't the EOR for this position. Instead, our role in this specific opportunity is to link outstanding candidates with a top-tier employer.