||Reimbursement Specialist, Central
Akcea Therapeutics, Inc. is a development and commercialization company focused on impacting the lives of patients with serious cardiometabolic lipid disorders. Our priority is to bring important new therapeutics to patients in need. In order to do so, we
must drive clinical program execution, understand patient and physician needs and work with regulators to gain global approval and market access to these new therapeutics.
Established as a subsidiary of Ionis Pharmaceuticals, Inc. in late 2014 and based in Cambridge, Massachusetts, Akcea was founded with a portfolio of development-stage drugs covering multiple targets and disease states using advanced antisense
therapeutics. In July 2017, Akcea closed its initial public offering of common stock and is listed on the NASDAQ Global Select Market under the symbol “AKCA.”
Nurse Reimbursement Specialist
Akcea Therapeutics is seeking Nurse Reimbursement Specialist (NRS) to join our team. The NRS will support the Field-Based Case Management Team to ensure patient access to treatment. The NRS interfaces with providers in community including case managers,
market access, coding and billing staff, patients and their caregivers.
The NRS will be responsible for developing relationships with professionals who support access to treatment for FCS patients. The Specialist will be directly involved in managing the multiple elements that comprise a patient’s successful transition onto
treatment and coordination of care to maintain compliance. This includes, but not limited to disease, diet, treatment, and reimbursement support. The NRS will back the Field-Based Case Manager during times of great demand for patient support.
- Maintain a current, proficient understanding of the Commercial Insurers, Medicaid, and Medicare Part D Benefit and Prescription Drug Plan (PDP) benefits with the changes each year.
- Collaborate to troubleshoot and resolve reimbursement-related issues with SPP, Market Access and insurance companies.
- Communicate reimbursement updates and findings to appropriate internal and external customers.
- Communicate and partner directly with internal cross-functional departments including: Patient Support and Experience team, Market Access, Field-base Case Manager, Medical and Patient Advocacy in order to prioritize tasks, organize,
and manage multiple projects related to access barriers.
- Partner with patients, providers and SPP to ensure all needs are met and appropriate support is being given on an individualized basis.
- Provide regular updates to Case Management regarding any outstanding access issues and update with specific plans.
- Develop and implement training for Case Managers as it relates to access.
- Ensure that all reimbursement training programs are consistent with, and supporting of, company regulatory and compliance guidelines
- Produce well-written documents, PowerPoint presentations, and Excel spreadsheets that communicate key points in a clear and concise format.
- Develop and implement pertinent funding work processes and policies for Case Management
- Float and assist aligned regional CM with cases as needed
- Participate in and complete required pharmacovigilance training.
- Comply with all relevant industry laws and Akcea policies.
- RN with current license required
- 3-5+years of case management and reimbursement experience
- 2+ plus years’ experience in pharmaceutical/ biotech industry
- Bachelor’s degree in Business, Healthcare, Marketing or Life Sciences, a plus
- Demonstrated knowledge of third party payers (Medicaid, Medicare and commercial) and case management process (prior authorization and appeals) required
- Working knowledge of CPT, ICD-9, HCPCS coding; facility, ASC and physician reimbursement. Medical billing and/or coding certification, a plus.
- Customer support, provider or payer relation experience with proven ability to establish strong working relationships with customers
- Strong communication, organizational and interpersonal skills (both written and verbal)
- Clinical, technical and scientific knowledge and aptitude in complex disease state
- Effective time management, resources allocation and workload management
- Ability to work in close collaboration with multiple departments including training, market access, patient advocacy and marketing in order to align on objectives and provide consistent feedback and communication.
- Must be proficient with Microsoft office
- Ability to work independently and as a team member
Excellent salary and benefits package offered.
For more information on Akcea and to apply for this position, please visit our website: www.akceatx.com Reference # 18-0090
NO PHONE CALLS PLEASE. PRINCIPALS ONLY.
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