Manager, Patient Access - San Diego, United States - MML US Inc

Description

Mainstay Medical

Mainstay Medical is a medical device company focused on marketing an innovative implantable neurostimulation system, ReActiv8, for people with disabling chronic mechanical Low Back Pain.

The company is headquartered in Dublin, Ireland, with subsidiaries operating in Ireland, the United States, Australia, and Germany.


The Role:

The Manager, Patient Access will have the primary responsibility of managing and developing the Mainstay Medical Patient Access Program and its associated teams.

The Patient Access team stewards Mainstay's relationship with patients and practices as they navigate their ReActiv8 journey through the healthcare system including patient qualification, benefits coordination, patient education, status visibility, obtaining insurance approvals for ReActiv8 and ultimately receiving the therapy.

The team consists of clinical Case Managers that operate remotely in support of patient awareness, education, and reimbursement for ReActiv8 as well as a San Diego based team of Prior Authorization Specialists that coordinate patient case submissions and appeals through to payers.

Position Responsibilities:

• Develop, train, and lead all Mainstay Medical Patient Access Program team members.
• Responsible for all aspects of Mainstay Medical's Patient Access program including team management, operating the current program, improving program efficiency and effectiveness, refreshing program strategy and operating model, setting goals and achieving results.
• Responsible for maximizing insurance approval rates through the management, update, and continuous improvement of submissions and appeals to payers in support of patients and physicans seeking ReActiv8 therapy for their patients.
• Responsible for influencing and optimizing the rate at which patients who are approved for ReActiv8 proceed to implant through patient education, organizational coordination, and team management.
• Maintain strong working relationship between the Patient Access Team and the field sales team they support.
• Directly partner with the field sales team to support program awareness, efficiency, uptake, and customer satisfaction.
• Utilize programmatic data, analytic capabilities, and relevant experience to drive employee productivity and functional stakeholder insights that improve overall program and individual team member performance.
• Advise necessary updates to automated platform to ensure proper workflow, visibility, and accountability.
• Develop and implement continuing education and necessary training of Mainstay Medical Patient Access Program team.
• Manage multiple priorities and deadlines successfully and handle stressful situations accordingly. Accepting risk and uncertainty.
• Ensure compliance with company compliance policy, in particular patient confidentiality (HIPAA) in all Mainstay Medical practices.
• Perform other duties as required.

Qualifications:

• Travel required up to 30% of the time.
• Bachelors degree and a minimum of 7 years related experience, with 2+ years of management experience, or equivalent work experience (medical device strongly preferred).
• Experience managing patient access programs and/or managing a clinical nursing team required.
• Experience working as part of and managing a remote team preferred.
• Knowledge and skillset with Salesforce platform, including system tools, integration components, reporting, etc. strongly preferred.
• Knowledge of health insurance industry practices/functions to include Medicare, Medicaid, and commercial and managed care organization's coverage policies.
• Skilled at patient engagement and interaction; experience in patient education is a plus.
• Problem solver and capable to find solutions to challenges or process impediments.
• Maintains a caring, empathetic, and patientcentric approach in all interactions.
• Demonstrate excellent organizational skills with attention to detail.
• Clear and professional written and verbal communication skills, both inperson and over the phone. Ability to communicate effectively with patients and health insurance partners.
• Experience with digital tools to enhance process efficiency (i.e., DocuSign, webbased forms, etc.)
• Proficient in computer operations, including Microsoft Word, Outlook, Excel, PowerPoint, and basic database management.

The salary range for this position is $130,000 to $180,000/year; however, base pay offered will take into account a range of factors, including job-related knowledge, skills, and experience.

The total compensation package includes a range of medical, dental, vision, financial, and other benefits, as well as equity.

Mainstay Medical is an Equal Opportunity Employer.

All qualified applicants will receive consideration for employment without regard to gender, race, color, religious creed, national origin, age, sexual orientation, gender identity, physical or mental disability, and/or protected veteran status.

Mainstay Medical participates