Case Manager, Patient Access

The Case Manager, Patient Access works in a highly visible and collaborative environment, working with Patient Access Managers, specialty pharmacies, and HCPs. The Case Manager will manage a caseload and work within a pre-determined process to help patients gain and maintain access to Xeris’ prescribed therapies. The Case Manager is accountable for providing exceptional service at all touch points and must anticipate and address challenges while understanding the time-sensitivity of each case. This role will develop and maintain relationships with patients and providers supporting therapy adherence.

• Understand the resources available in their specific geography and how they can be best deployed to support patient care.
• Develop action plans that provide for the initiation and continuation of treatment with Xeris products and services.
• Foster collaborative relationships with all internal and external customers including but not limited to Patient Access Managers, Medical, Sales, National Accounts, Patient Advocacy, specialty pharmacy, and HCPs.
• Assist in obtaining insurance approval for Xeris’ therapies, and proactively plan for maintenance of coverage by working with specialty pharmacy, Patient Access Managers, HCPs, payers, and Xeris colleagues.
• Develop a comprehensive understanding of the reimbursement process, insurance plans, payer trends, patient assistance programs, and related patient resources.
• Troubleshoot cases while interfacing with key stakeholders (internal/external) to ensure optimal start to therapy.
• Maintains accurate data on every case, coverage approvals, on-going coverage requirements and all patient and provider interactions.
• Ensures compliance with all corporate and industry policies in collaboration with Xeris Legal and Compliance.
• Maintain disease, reimbursement, and insurance coverage expertise through continuing education and attendance at relevant conferences and other educational opportunities.

• Working Conditions
• Ability to navigate difficult conversations and handle sensitive issues with opposing opinions.
• Knowledge of Commercial payers, Medicare, and Medicaid reimbursement processes required.
• Frequent travel up to 20% domestically.
• Competencies Customer Service focus, Teamwork & Collaboration, Attention to Detail, Self-Starter, Problem Solving, Organizational skills, Adaptability, Professionalism, Written and Verbal Communications,
• 2+ years recent case management experience in the healthcare or pharmaceutical/biotech industry. Ultra-rare disease experience a plus.
• Experience should include healthcare case management, insurance reimbursement, prior authorization and appeals, patient assistance programs, and billing and coding.
• Experience administering self-insured medical plans in a corporate environment, liaising between participants and insurance carriers and assisting in the prior-authorization process is a plus.
• Bachelor’s Degree in Health Sciences, Business/Marketing, Nursing or related field; Advanced degree preferred.
• Must be able to support regional geographies and time zones.
• Position may require periodic evening and weekend work, as necessary to fulfill obligations.

As an equal employment opportunity and affirmative action employer, Xeris Pharmaceuticals, Inc. does not discriminate on the basis of race, color, religion, sex, gender identity, sexual orientation, national origin, age, disability, veteran status, genetics or any other characteristic protected by law. It is our intention that all qualified applications are given equal opportunity and that selection decisions be based on job-related factors.