Clay Hall, MBA-HM, PACS, RRT, RCP
Abbeville,SC
Summary
Confident Therapy Access Manager promoting effective communication, relationship building and time management skills. Offering over 10 years of expertise in patient support roles and navigating the everchanging payer landscape. Driven and talented leader with aptitude for teamwork.
Overview
17
17
years of professional experience
1
1
Certification
Work History
Therapy Access Manager (TAM)-Carolinas-Pulmonary Hypertension
The Janssen Pharmaceutical Companies of Johnson & Johnson
11.2019 - Current
- Equip HCPs and their staff, through education, to navigate the access and payer approval process, identify access barriers that the HCP must act to overcome, and highlight HCP actions that support access to therapy
- Develop and execute an education plan consisting of prioritized activities to best educate the HCPs in territory
- Monitor, analyze, and triage situations which may adversely impact patient access to therapy
- Liaise with entire Market Access department, other internal groups including sales, and medical groups, and HCPs to identify and resolve trending issues regarding patient access to therapies
- Serve as a member of the Training Liaison and Marketing Liaison Team
- Educate HCPs regarding the access and payer approval process for Actelion therapies
- Serve as subject matter expert for internal stakeholders and external HCPs regarding education on Medicare treatment guidelines, Medicaid Managed Care, commercial plans, PBM designs, policy changes, formulary status and the impact of healthcare reform on PAH coverage
- Maintain and share relevant information regarding account contacts, prior authorization requirements, trends, competitive intelligence, etc
- With the Market Access Department
- Educate peers in the Customer Care Area about various elements of Market Access, including reimbursement, medical coverage policies and medical versus pharmacy benefit designs
- Execute business in accordance with the highest ethical, legal, and compliance standards, including timely and successful completion of all required training
Pulmonary Disease Navigator/Pulmonary Hypertension Program Coordinator
AnMed Health
07.2016 - 11.2019
- Responsible for development and maintenance of Pulmonary Hypertension Program
- Received accreditation from PHA (Pulmonary Hypertension Association) for Regional Clinical Program
- 1 of 8 in United States
- Reimbursement expertise by understanding coverage policy of the insured; navigating prior authorization and appeal process for all PAH related drugs
- Serve as the Outpatient Respiratory Disease Transitional Care Coordinator, includes development and implementation of patient centered discharge pathway to support self-management of COPD to prevent readmissions
Clinical Liaison
Regency Hospital Company
06.2015 - 07.2016
- Work with physicians, discharge planners, and patient families to plan the best continuum of care for post-ICU patients
- Perform clinical assessments of referred patients, then counsel with patient families to assist them in making the best care decisions for their loved-one
- Partner with hospital case managers to create smooth patient transfer processes and to help remove payer-related and operational barriers to getting appropriate patients into this highly effective level of care
Clinical Manager - Respiratory Care
AnMed Health
05.2009 - 06.2015
- Managing a staff of up to 15 respiratory therapists, including hiring, orienting, educating, mentoring, scheduling, team building, competency reviews, continuing education, and performance evaluations
- Coordinating with physicians to develop protocols, arrange for care plans, and maximize quality care
- Delivering all modes of respiratory therapy to patients in all patient care areas per hospital protocol
- Evaluating customer service through daily rounding, anticipating and acting to prevent potential customer service problems, and providing service recovery as necessary
- Representing the respiratory department on multidisciplinary project teams
- Acquiring and analyzing data including charting audits, clinical indicators, and regulatory compliance audits and implementing tools to maximize performance
Respiratory Care Practitioner
AnMed Health
01.2007 - 05.2009
- Delivering all modes of respiratory therapy to patients in all patient care areas per hospital protocol
- Serving as charge therapist in absence of clinical manager
Adjunct Clinical Instructor
Piedmont Technical College
01.2009 - 01.2009
- Instructed students on the basics of Respiratory Care and communication skills in the hospital setting
Education
MBA - Healthcare Management
Columbia Southern University
Orange Beach, AL11.2023
Bachelor of Science - Health Administration
Columbia Southern University
Orange Beach, AL01.2013
Associate of Science - Respiratory Care
Piedmont Technical College
Greenwood, SC01.2007
Skills
- Managed Care Reimbursement
- Leadership Development
- Building and Coaching Teams
- Direct Patient Care
- Staff Training and Development
- Medical Education
- Management
- Payer Landscape Expertise
Accomplishments
- Southeast TAM of the Year 2021-Janssen PH
- Regional Clinical Program-Pulmonary Hypertension Association
Certification
- Pulmonary Disease Educator
- Registered Respiratory Therapist (RRT) - American Association for Respiratory Care (AARC)
- Respiratory Care Practitioner - SCDLLR
- Prior Authorization Certified Specialist - Accreditation Council for Medical Affairs (ACMA)
Timeline
Therapy Access Manager (TAM)-Carolinas-Pulmonary Hypertension
The Janssen Pharmaceutical Companies of Johnson & Johnson
11.2019 - Current
Pulmonary Disease Navigator/Pulmonary Hypertension Program Coordinator
AnMed Health
07.2016 - 11.2019
Clinical Liaison
Regency Hospital Company
06.2015 - 07.2016
Clinical Manager - Respiratory Care
AnMed Health
05.2009 - 06.2015
Adjunct Clinical Instructor
Piedmont Technical College
01.2009 - 01.2009
Respiratory Care Practitioner
AnMed Health
01.2007 - 05.2009
MBA - Healthcare Management
Columbia Southern University
Bachelor of Science - Health Administration
Columbia Southern University
Associate of Science - Respiratory Care
Piedmont Technical College
- Pulmonary Disease Educator
- Registered Respiratory Therapist (RRT) - American Association for Respiratory Care (AARC)
- Respiratory Care Practitioner - SCDLLR
- Prior Authorization Certified Specialist - Accreditation Council for Medical Affairs (ACMA)
Similar Profiles
GALILEE MerinoGALILEE Merino
Speaker/Consultant at Janssen Pharmaceutical Companies of Johnson & JohnsonSpeaker/Consultant at Janssen Pharmaceutical Companies of Johnson & Johnson
Marie FlorestalMarie Florestal
Sr. Global Quality Consultant at Janssen Pharmaceutical Companies Of Johnson & JohnsonSr. Global Quality Consultant at Janssen Pharmaceutical Companies Of Johnson & Johnson
Simret LuluSimret Lulu
Salesforce Support Analyst at The Janssen Pharmaceutical Companies of Johnson & JohnsonSalesforce Support Analyst at The Janssen Pharmaceutical Companies of Johnson & Johnson