The Field Access Navigator (FAN) will be a subject matter expert on access & reimbursement for dordaviprone, working remotely within their assigned geography to provide education and case-specific support to internal and external stakeholders including but not limited to health care providers (HCPs), sales force, Specialty Pharmacy, and our Sr. Director of National Access. The Access & Reimbursement Manager must have extensive expertise in navigating insurance and access related barriers and will be a highly collaborative individual who proactively manages multiple priorities in a fast-paced environment (e.g., fielding daily questions from the sales team, working with Hub, specialty pharmacy partners, and office contacts to move patients through the reimbursement process, accurately updating daily reports).
Proactive office support and education on Chimerix Cares support programs and new patient starts:
- Educate providers and their staff on the available support programs for dordaviprone and how to access them through Chimerix Cares.
- The Field Access Navigator (FAN), serves as the key contact responsible for patient access and reimbursement in an assigned geography that provides appropriate support to providers and professional staff, including how to complete the Chimerix Cares enrollment form, the Specialty Pharmacy process, requirements for prior authorization approvals, appeal approvals, and any relevant coverage policy steps pertaining to insurance approval.
- Cultivate relationships within targeted offices and serve as a familiar and readily available resource for obtaining access and insurance coverage for dordaviprone.
· Closely monitor cases as they progress through the patient onboarding process Escalated Support for Specific Cases:
- Proactively identify and solve complex patient access issues by working across the Hub, HCP offices and communicating with field teams. Educate physicians (in-person or virtual) on escalated access and insurance issues.
- Assist physicians and office staff when enrollment forms are submitted with information missing; coordinate with the Specialty Pharmacy and Hub team to clearly explain to the office what information is missing.
- Assist physicians and office staff in resolving access issues (prior authorization, appeals, denials, letters of medical necessity), and help ensure appropriate education to avoid future access hurdles/delays
- Effectively partner with access stakeholders (specialty pharmacy, sales team, HCP office, Sr. Dir of National Access, etc.) to communicate challenges, identify solutions, and ensure patients are progressing through the coverage approval and support program process.
Sales Force Communication / Partnership:
- Proactively seek out timely and regular updates on case statuses, leveraging network of access stakeholders
- Periodically ride with and educate sales force on complexities surrounding the insurance approval process. Maintain a level of expertise on specific payors and the requirements for claim approvals.
- Log calls and notes within standardized platform daily, to provide clear and concise updates that drive toward action and emphasize next steps and owners (based on standardized template)
- Lead case status update meetings with sales force and sales leadership in a way that demonstrates confidence and preparedness and emphasizes specific next steps / owners
- Coordinate with Hub and specialty pharmacy to regularly share information and work together to move cases forward efficiently and smoothly
- Operate in compliance with HIPAA within program guidelines
Proactive Trend Identification and Key Account Education:
- Deliver expertise in regional and local access landscape, anticipating changes in the healthcare landscape, and act as the Subject Matter Expert for insurance coverage.
- Know your business to identify trending barriers to payer access within your geography and create action plans to resolve them.
- Work with market access team to monitor national and regional payer trends and changes, then educate both internal (sales) and external (HCPs) on changes
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