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Field Reimbursement Liaison - Northeast

External
crinetics logoCrinetics · Worldwide
Full-timeRemote2w ago
CRMExcelICD-10LeadershipProcess Improvement
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Benefits

Health insurance

Additional Information

Crinetics is a pharmaceutical company based in San Diego, California, developing much-needed therapies for people with endocrine diseases and endocrine-related tumors. We were founded by a dedicated team of scientists with the simple belief that better therapies developed from rigorous innovation can lead to better lives. Our work continues to make a real difference in the lives of patients. We have a prolific discovery engine and a robust preclinical and clinical development pipeline. We are driven by science with a patient-centric and team-oriented culture. This is an exciting time to join Crinetics as we shape our organization into the world's premier fully-integrated endocrine company from discovery to patients. Join our team as we transform the lives of others. Position Summary: The Field Reimbursement Liaison (FRL) - Northeast provides access & reimbursement assistance to optimize the patient experience with Crinetics' products. The FRL is regionally based and coordinates a cross-functional team in ensuring patients have access to treatment. The FRL interfaces with healthcare professionals, including their ancillary staff, nurse case managers (NCMs), HUB coordinators, Market Access team, and various Channel Partners on complex access and reimbursement cases by providing education on Crinetics sponsored patient programs and process guidance in response to prior authorizations, resubmissions, and denials. Essential Job Functions and Responsibilities: These may include but are not limited to: Conduct office calls with HCPs and/or office staff for support with appropriate patient access to Crinetics' products, including assistance in resolving reimbursement, patient programs, and coverage questions. Resolve issues associated with patient coverage, access, and reimbursement in collaboration and coordination with patient services as directed by policy. Proactively communicate Crinetics' patient services programs, policies, procedures, and resources so that office staff (i.e., practice manager, nursing, billing, and reimbursement staff) are fluent in how to use our sponsored programs and systems. Liaise with CrinetiCARE (Crinetics Patient Support Center) and our network Specialty Pharmacies. Provide strategic coverage/reimbursement leadership and support to the internal Crinetics Sales team. Recommend and implement process improvement updates/changes to improve the patient experience. Serve as the subject matter expert on the reimbursement / access landscape, including payer policies, prior authorization requirements, denials, appeals, peer to peer, and other education required to navigate access. Provide insights and updates regarding product and support service integration at HCP and Hospital Pharmacy accounts. Conduct quarterly reviews with practices on their utilization of Crinetics patient services to better enhance our offerings to patients. Create training materials and deliver education programs to sales force, physicians, pharmacy directors, billing personnel, and other internal and external stakeholders as needed. Keep abreast of customer and market access industry trends; analyze access/reimbursement issues and opportunities. Maintain a deep understanding of Crinetics policies and requirements and perform all responsibilities in a manner consistent with company guidance. Handle PHI appropriately. Education and Experience: Required: Bachelor's degree required with a minimum of 12 years' experience in healthcare and/or pharmaceutical/biotech industry. Clinical, technical, and scientific knowledge and aptitude in complex/rare diseases. Strong communication, organizational, and interpersonal skills (both written and verbal). Ability to gain high levels of credibility and excellent persuasion skills to achieve desired results. Knowledge of third-party payers (Medicare, Medicaid, commercial) and case management process (prior authorization and appeals). Demonstrated technical aptitude and working proficiency in using iPad and working proficiency in Microsoft Word, Excel, PowerPoint, and Outlook. Effective time management, resources allocation, and workload management. Comfort with ambiguity and the ability to adapt continuously. Demonstrated responsiveness and a sense of urgency. Ability to balance strategic thinking/analytical analysis with tactical execution. Functional and cross-functional teamwork experience. Ability to work independently. Must live within territory or within territory boundaries assigned for the position. Preferred: At least 3-5 years of access and reimbursement experience. Case management and Customer Relationship Management (CRM) systems experience. Minimum of 2 years' experience working with specialty pharmacy networks. Strong understanding of US health care policy and payment systems, including hospital and physician reimbursement. Working knowledge of CPT, ICD-10, HCPCS coding; site of care reimbursement environment (infusion site, physician off


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