Cynthia Cruz
Hayward,CA
Summary
Compassionate Patient Advocate with background in healthcare and social services. Experience includes working closely with patients to understand medical needs, communicating effectively with medical professionals, and navigating complex healthcare systems. Strengths lie in outstanding interpersonal skills, strong problem-solving abilities, and deep commitment to patients.
Overview
15
15
years of professional experience
1
1
Certification
Work History
Director of Patient Access
NS Pharma
11.2023 - Current
- Develops and executes geographical strategic and tactical plans to meet customer and business needs for 15 states including education and support about support programs and available prior authorization and reauthorization patient access services
- I partner with internal colleagues across Sales, Market Access, Patient Services, Medical, Trade, etc
- And our external sites of care, and external HUB to develop compliant cooperation and deliver coordinated information and to all applicable parties, whether internal or external
- I foster and build upon meaningful relationships with external stakeholders in all sites-of-care to include physician practices, hospitals and alternative sites of care to provide meaningful support for the patient journey
Patient Engagement Lead
NS Pharma
02.2023 - 10.2024
- Manage insurance support for ultrarare specialty infusion medication
- I was the primary patient interface, facilitating initial authorization, reauthorization, and ordering
- This role is essential in ensuring the seamless delivery and administration of medication and resolving access issues
- I also provide educational guidance to patients and caregivers regarding Duchenne Muscular Dystrophy advocacy groups and related resources
- I act as the primary point of contact for national and regional patient advocacy events
- Evaluating and explaining Patient Assistance Program /Free goods programs, Quick Start, Bridge, co-pay, and other affordability programs
- Collaboration with various stakeholders, including Directors of Patient Access, Duchenne Account Specialists, Medical Science Liaisons, and National Account Directors, is fundamental
- This collaborative approach addresses patient access issues comprehensively, often requiring coordination with NS Support Hub Case Managers
- Creating educational marketing materials that target families and Key Opinion Leaders, emphasizing the vital role of patient education and awareness in this domain
Field Reimbursement Manager
Urogen
01.2022 - 02.2023
- Collaborated with a Regional Business Director, 7 Territory Business Managers, 3 National Account Directors, 2 Clinical Nurse Educators, and a Key Account Director to service ten states on the West Coast for an Orphan Disease UroOncology Drug
- Directed the Market Access training and development of new Territory Business Managers, leading to increased customer satisfaction, sales, and, ultimately, profitability for the company
- Drove medication approval and met customer needs through effective communication and collaboration with physicians, pharmacy staff, and a third-party HUB vendor
- Educated and coordinated with C-Suite executives, Physicians, Sterile Processing, Pharmacy, and Therapeutics Committees in various Academic institutions, IDNs, and Ambulatory Surgery Centers to facilitate adoption, administration, and satisfactory reimbursement
- Evaluated and explained Patient Assistance Program/Free goods programs, co-pay, and other affordability programs
- Conduct office calls with HCPs and office staff that needed support to enable appropriate patient access to Pfizer products, including assistance in resolving reimbursement and coverage questions
- Provided education for HCPs/office staff regarding local/regional payer landscape, payer coverage and formulary change updates, payer policies (e.g., prior authorization, step edits, specialty pharmacy coverage), and patient support
- Coordinated reauthorization process at designated accounts to ensure timely reauthorization and continuation of therapy is maintained
Program Manager
Infinitus
10.2019 - 12.2021
- Played a pivotal role as one of the six founding members of a dynamic company
- Together, we established a groundbreaking conversational Artificial Intelligence platform designed to engage with insurance companies, conducting benefit investigations for specialty medications
- Our primary objective was to drive down healthcare costs and expedite patients' access to care
- Impactfully contributed by formulating corporate objectives and strategies
- Collaborated on quality metrics, key performance indicators (KPIs), and Standard Operating Procedures and led cross-functional teams in devising improvement measures related to quality
- Took the initiative to develop a comprehensive training curriculum for new employees, incorporating mentorship, employee development, and growth opportunities
- In my leadership capacity, I supervised and nurtured a high-performance team of seven Team Leads across three clients and eight specialty medications
- I consistently delivered performance reviews, feedback, and coaching, addressing both areas of excellence and areas for improvement
- Extensively involved in designing the customer-facing elements of the portal, working closely with the engineering team and customers to ensure an optimal user experience
- Spearheaded the remarkable expansion of the HUB Services team from 2 to over 150 members across 15 states and two overseas vendors during the challenging times of the COVID-19 pandemic
- Evaluated and explained PAP/Free goods programs, co-pay, and other affordability programs
Patient Access Specialist
Syneos
01.2019 - 10.2019
- Acted as an extension of the external HUB and provided reimbursement education by leveraging Patient Healthcare Information (PHI) to support the benefits investigation and prior authorization processes for the launch of a REMS Neuroscience product
- Delivered education on operational requirements in compliance with FDA, federal, and state-level regulations for handling controlled medication
- Collaborated closely with Clinical Specialists and Key Account Directors to effectively communicate with targeted accounts
- Evaluated and explained PAP/Free goods programs, co-pay, and other affordability programs
Patient Access Specialist
Xcenda
10.2017 - 12.2018
- Facilitated live training and education sessions on reimbursement for our client's products
- This included educating on using patient assistance and reimbursement support services and demonstrating web-based provider programs to physician offices
- Provided coding education to physician offices focusing on Dermatology and Gastroenterology specialty medications, covering both buy and bill and specialty pharmacy benefits
- Volunteered to monitor national payer policies and authorization requirements and kept physicians and the internal team updated as necessary
Senior Reimbursement Specialist
Genentech
10.2009 - 09.2017
- Honored to receive the Field Reimbursement Collaboration Award while working with Managed Care Marketing on Rotation
- Responsible for completing and providing data trending and analysis of payer policies to our internal reimbursement partners and field sales team
- Recognized the need for an Intelligence repository for payer behavior and processes for all Genentech products
- Designed and implemented this system, which resulted in the management of a team of 11 Reimbursement Specialists to maintain and update the system
- Developed Standard Operating Procedures for the Access Solutions team and was a Compliance Captain
- Completed a rotation with Genentech Access to Care Foundation, where I evaluated eligibility for a free drug program and worked closely with patients and physician offices
- Developed and delivered training curricula to contract Reimbursement Specialists and assumed the responsibility of interviewing and selecting incoming contract Reimbursement Specialists
- Conducted benefit investigations for various biologic specialty medications, including buy and bill, specialty pharmacy, orals, launches, miscellaneous J codes, all levels of appeals, Medicare B, C, and D, as well as 340B programs, demonstrating a comprehensive understanding of the reimbursement landscape
Education
MS - Rehabilitation Counseling
West Virginia University
BS - Criminal Justice
West Liberty University
Skills
- Task prioritization
- Relationship building
- Interpersonal communication
- Organizational skills
- Supervision and leadership
Certification
Prior Authorization Certification Specialist, Accreditation Council for Medical Affairs
Timeline
Director of Patient Access
NS Pharma
11.2023 - Current
Patient Engagement Lead
NS Pharma
02.2023 - 10.2024
Field Reimbursement Manager
Urogen
01.2022 - 02.2023
Program Manager
Infinitus
10.2019 - 12.2021
Patient Access Specialist
Syneos
01.2019 - 10.2019
Patient Access Specialist
Xcenda
10.2017 - 12.2018
Senior Reimbursement Specialist
Genentech
10.2009 - 09.2017
MS - Rehabilitation Counseling
West Virginia University
BS - Criminal Justice
West Liberty University
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