Requisition ID: 6212
Job Title: Manager, Patient Access (Remote)
Job Country: United States (US)
Here at Avanos Medical, we passionately believe in three things:
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Making a difference in our products, services and offers, never ceasing to fight for groundbreaking solutions in everything we do;
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Making a difference in how we work and collaborate, constantly nurturing our nimble culture of innovation;
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Having an impact on the healthcare challenges we all face, and the lives of people and communities around the world.
At Avanos you will find an environment that strives to be independent and different, one that supports and inspires you to excel and to help change what medical devices can deliver, now and in the future.
The Avanos COVID-19 Vaccine Policy: This Policy applies to U.S. customer-facing / field-based employees & Avanos leadership: All U.S. customer-facing / field-based employees hires must be fully vaccinated against COVID-19. Proof of being fully vaccinated does not need to be disclosed until a job offer has been made but must be submitted within 48 hours after the acceptance of the job offer. If you have a qualifying medical condition or sincerely held religious belief or practice that precludes you from receiving a COVID-19 vaccine, you may apply for an exemption or deferral after you accept the job offer and before your scheduled start date. The reasonable accommodation provided to the employee, if any, will depend on the employee’s job and the applicable facts, but it may include weekly COVID-19 testing and masking requirements. New hires who do not submit, before their scheduled start date, proof of being fully vaccinated or a request for a reasonable accommodation will have their job offer revoked.
Avanos is a medical device company focused on delivering clinically superior breakthrough solutions that will help patients get back to the things that matter. We are committed to creating the next generation of innovative healthcare solutions which will address our most important healthcare needs, such as reducing the use of opioids while helping patients move from surgery to recovery. Headquartered in Alpharetta, Georgia, we develop, manufacture and market recognized brands in more than 90 countries. Avanos Medical is traded on the New York Stock Exchange under the ticker symbol AVNS. For more information, visit www.avanos.com.
SUMMARY
The Patient Access Manager is part of the Market Access, Reimbursement, and Medical Policy (MA&R) team. The MA&R team supports internal and external customers navigate through reimbursement nuances and barriers, the facilitation of authorizations and appeals, and collaborates with key opinion leaders, Specialty Societies, Government organizations, and payer decision makers to influence coverage via policy change in efforts to increase access to Avanos products. This role will primarily focus on the Avanos Pain Management and Recovery product portfolios, radiofrequency ablation products.
The Patient Access Manager is a subject matter expert who will be directly responsible for development, oversight, and management of the Avanos Patient Access Program and team, and strategic initiatives in efforts to optimize access to Avanos Medical’s Pain Management and Recovery portfolio products.
PRIMARY RESPONSIBILITIES
- Develops, implements, and manages the Avanos Patient Access Program and team members; including but not limited to program operations and processes to ensure superior support is provided, processes are followed, and compliance is maintained.
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Hires and manages direct reports, including but not limited to performance reviews, time-off requests; ensuring superior support is provided, processes are followed, compliance is maintained, and direct reports are able to function in a productive, accurate, and efficient manner.
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Is an expert level resource to provide on-the-job training for new hires, ongoing training, guidance, mentoring, and support to direct reports to resolve complex patient access issues and advance knowledge, foster career growth and expand team capabilities.
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Performs frequent internal reviews and audits to ensure program operations remain aligned with strategic initiatives and direct reports are performing effectively as defined in program process and procedures documents, monitors case assignments to assess productivity, hiring needs, and serves as a back-up to ensure adequate staffing is available for all operations under the Patient Access Program.
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Provides expert level acumen and support on patient access program processes and initiatives to support internal and external customers. Serves as the primary source of contact for addressing issues more complex than others serving on the Patient Access team may be required to know in an accurate, consistent, timely and compliant manner.
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Analyzes program outcomes and recognizes trends/issues that hinder patient access, crafts strategic and tactical recommendations, and implements initiatives to adapt the program operations based on changing payer processes and requirements and to improve program outcomes and efficiency; including but not limited to program resources and collateral, processes, and procedures, as well as training documents and plans.
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Fosters a strong alliance with the MA&R Team in the identification applicable market access, reimbursement, and payer coverage changes and/or trends at the customer, regional, and national levels that may impact patient access to Avanos products. Partners in the development and pull-through of strategic initiatives in efforts to increase access and neutralize barriers to Avanos products.
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Aids in the development, preparation, and presentation of educational materials regarding patient access and program outcomes (e.g., training, workshops, and presentations).
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Establishes professional relationships and maintains an effective communication network with the internal and external customer at multiple levels.
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Participates in the operations of the Avanos Patient Access Program as needed; including but not limited to data entry, preparing, and facilitating appeals, collecting necessary documentation to fulfill payer requirements, and processing payer determinations.
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Demonstrates uncompromised ethics while helping others understand legal and regulatory parameters related to patient access and adheres to Corporate Compliance programs and successfully participates in training and continuing education programs.
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Performs other duties and projects as required/needed.
QUALIFICATIONS / EDUCATION / EXPERIENCE
Required Qualifications:
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Minimum of 3 years’ experience within patient access, medical benefits, health insurance standards and authorization processes, and reimbursement with a comprehensive understanding of obtaining patient access of procedures across government and private payer environments specific to surgical procedure(s), and/or medical device(s), and/or DME, and/or biologic(s).
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Minimum of 2 years’ experience with direct oversight and management of the operations of a patient access program and team with a successful record of managing direct reports.
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Advanced, in-depth knowledge of medical benefits, insurance standards, pre- service insurance authorization processes and requirements for reimbursement from government and private payers and ability to locate and interpret payer pre-service review requirements, policies, coverage determination making processes, etc.
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Experience with educational presentations to external and internal customers with exemplary ability to provide superior support to internal and external customers and to expertly navigate through challenging situations.
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Collaborative work ethic, exemplary leadership skills, excellent project and time management and communication (written and verbal) skills.
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Proficient in using Microsoft PowerPoint, Excel, Windows, and Microsoft Office. Experience with data visualization software (e.g., Tableau) and CRM applications (e.g., Salesforce.com) or aptitude to learn such tools. General ability to learn and acclimate to new systems.
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Working knowledge of compliance and regulatory mandates in medical device/technology environments; including but not limited to HIPAA, HITECH, ADVAMED, and Federal Statutes.
JOB POSITION SCOPE
Travel – less than 10%
Salary Range:
The anticipated average base pay range for this position is $107,681 - $179,432. In specific locations, the pay range may vary from the base posted.
Avanos Medical is an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, sexual orientation, gender identity or any other characteristic protected by law. If you are a current employee of Avanos, please apply here
Join us at Avanos
Join us and you can make a difference in our products, solutions and our culture. Most of all, you can make a difference in the lives, people, and communities around the world.
Make your career count
Our commitment to improving the health and wellbeing of others begins with our employees – through a comprehensive and competitive range of benefits. We provide more than just a salary – our Total Rewards package encompasses everything you receive as an employee; your pay, health care benefits, retirement plans and work/life benefits.
Avanos offers a generous 401(k) employer match of 100% of each pretax dollar you contribute on the first 4% and 50% of the next 2% of pay contributed with immediate vesting.
free onsite gym | benefits on day 1 | HQ region voted ‘best place to live’ by USA Today
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