Glaukos is Growing! Join Our New GPS - Glaukos Patient Services Team
How will you make an impact?
The Patient Reimbursement Liaison team is part of Glaukos Patient Services (GPS), and will serve as experts in payer policies, patient, and provider support to facilitate appropriate patient access services to ensure patients have access to Glaukos' sight saving technologies.
The Patient Reimbursement Liaison works with physician practices (both private and hospital affiliated institutions). They interact directly with key management personnel, providers and staff members to assure patient access to care. The Patient Reimbursement Liaison appropriately educates HCPs and their office staff on clinical documentation, securing treatment approvals, patient tracking, claim submission, reconciliation management, patient education, drug inventory, patient copay assistance and drug acquisition channels. The Patient Reimbursement Liaison helps HCPs understand barriers that may impede or delay appropriate patient access to treatment and/or prevent optimal patient outcomes. Additionally, the Patient Reimbursement Liaison provides education on appropriate and accurate billing and coding practices for Glaukos' products in line with payer requirements and to the highest levels of specificity.
This candidate must be organized and detail oriented. Demonstrated teamwork and collaboration abilities with high emotional intelligence in managing multiple business initiatives and cross-functional relationships will be a requirement.
What will you do?
Specific responsibilities include but are not limited to:
- Provides HCPs and their office staff education on how to interpret benefit verifications including PA requirements, calculation of patient cost share and drug acquisition options for specific patients enrolled in GPS.
- Collaborates with Patient Support Specialist (PSS) to identify and eliminate barriers to access for patients enrolled in GPS.
- Responds to HCP questions related to coding, payer policy, and approval protocols.
- Offers expertise on navigating copay assistance for appropriate patients enrolled in GPS.
- Provides education on navigating the appeals process as well as denied and partially paid claims.
- Takes lead in completing Business Reviews and Claims Reviews for practices.
- Provides education on specialty pharmacy and buy & bill acquisition options.
- Monitors reimbursement trends (e.g., HCPs receiving notification of policy changes, claim denials, underpayments, etc.) and engages payer team appropriately when patient access may be jeopardized.
- Maintains expertise in regional and national payer landscapes, specifically, proper clinical requirements, reimbursement policy, utilization management criteria, prior authorization processes and appeal requirements.
- Updates customers on policy changes through approved templates and plan approval.
- Identifies coverage gaps and computer errors on policy requirements or portal entry challenges that inhibit patient access to care.
- Manages all forms of communication in a timely and professional fashion to ensure customer needs are fully met and all relevant internal stakeholders are appropriately updated.
- Demonstrates positive leadership, without authority, to peers, upper management and other stakeholders by leveraging skills and expertise in account management.
- Successfully completes assigned training.
How will you get here?
- Bachelors Degree in related field. MBA or MPH preferred.
- 7+ years of experience working with specialty pharmaceuticals or devices and a minimum of 1 year in a patient access-related position.
- Reimbursement experience with physician-administered injectables and/or medical devices, Category III CPT codes and/or miscellaneous J-codes, specialty pharmacy and buy & bill acquisition, and benefit verifications, prior authorizations, claims assistance, and appeals.
- Payer/insurance coverage experience with Medicare, Medicare Advantage, VA/Tri-Care, Commercial and Medicaid plans.
- Proven record of accomplishment in achieving objectives and corporate goals with minimal direct supervision and demonstrated creativity, situation analysis/problem solving skills and analytical skill ability..
- Demonstrated leadership and project management skills with excellent communication skills, including written, verbal and listening. Strong presentation and training skills.
- Significant experience working with a Patient Service Center/Hub.
- Successful navigation of complex authorization processes for specialty medications, Orphan, or Rare disease.
- Educate Healthcare Professionals on the availability of patient support programs such as Co-Pay Assistance and Patient Assistance Programs.
- Ability to travel adequately to cover territory, as well as overnight travel (~50%) and attendance at scheduled training and meetings.
- Previous sales, district management, field reimbursement, hospital or practice experience preferred.
- Eyecare experience preferred.
These are just a few of the terms our employees use to describe their experiences as a part of the Glaukos family.
Those may seem like big aspirations, but here at Glaukos, we recognize the deep significance and profound meaning that comes from knowing that we can make a meaningful difference by helping improve eyesight of people worldwide. And because we're a rapidly growing company with a dynamic, fast-paced culture, individual employees are empowered with more diverse and enriching challenges that might not be possible at a larger company, and more fulfillment in knowing every person and every task is directly tied to making a difference in the life of others.
We offer competitive salary (based on experience), bonus eligibility, medical/dental/vision, life insurance, stock options, 401(k) Employer Match, Employee Stock Purchase Program, generous time off & paid holidays as well as time-off to volunteer in the community, plus the opportunity to work for a company that is pioneering a new glaucoma treatment class! Moreover, Glaukos Corporation has been Certified as a Great Place to Work the last two years!
Glaukos Corporation is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex including sexual orientation and gender identity, national origin, disability, protected Veteran Status, or any other characteristic protected by applicable federal, state, or local law.
Founded in 1998, Glaukos Corporation is an ophthalmic medical technology and pharmaceutical company focused on novel therapies for the treatment of glaucoma, corneal disorders, and retinal diseases.
Our company was the first company to bring to market Micro-Invasive Glaucoma Surgery (MIGS), the micro-invasive procedure which revolutionized the treatment and management of glaucoma. In 2012, we launched our first MIGS device-the iStent®-in the United States, followed by our next-generation iStent inject ® device in September 2018 and iStent inject ® W in September 2020.
In November 2019, Glaukos acquired Avedro, maker of the first and only FDA-approved cross-linking technology for progressive keratoconus. And we continue to seek to leverage our platform technologies to build a comprehensive and proprietary portfolio of micro-scale surgical and pharmaceutical therapies for glaucoma, corneal health, and retinal diseases.
Our company completed an initial public offering in June of 2015, and our shares are traded on the New York Stock Exchange under the ticker symbol "GKOS". Our global headquarters is located in San Clemente, California with additional locations in Waltham and Burlington, Massachusetts.
Glaukos Corporation is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employmentwithout regard to race, color, religion, sex including sexual orientation and genderidentity, national origin, disability, protected Veteran Status, or any othercharacteristic protected by applicable federal, state, or local law.