ERIKA AGUIRRE MSN APRN PACS
Weslaco,TX
Summary
Results-driven Manager with extensive experience in Immunology, Cardiology, Sales, Access and Reimbursement, and Education. Developed and implemented effective reimbursement strategies for patient access programs, while collaborating with field teams to overcome reimbursement barriers and support sales initiatives. Trained staff on reimbursement processes and maintained compliance with evolving policies, leveraging technology tools to optimize operational efficiency.
Overview
13
13
years of professional experience
Work History
Field Access and Reimbursement Manager
Johnson & Johnson
Corpus Christi, Texas
08.2024 - Current
- Developed and executed reimbursement strategy for Johnson & Johnson patient access programs, enhancing patient access.
- Reviewed payer policies, coverage criteria, and prior authorization requirements.
- Advised field teams on reimbursement barriers and account support, facilitating effective issue resolution.
- Collaborated with sales and market access teams to address customer needs, improving alignment and support.
- Trained staff on reimbursement processes, forms, and documentation standards.
- Monitored policy changes affecting Johnson & Johnson product access.
Field Access Manager
Synecos Health
Corpus Christi, TX
03.2021 - 05.2024
- Knowledge of centers of Medicare & Medicaid Services (CMS) policies and processes with expertise in Medicare Part D.
- Coordinate cross functionally with Field Sales, Marketing, Market Access, Public Affairs, State & Government Affairs, Trade, Specialty Pharmacy Account Management and applicable third party affiliates.
- Tracked prior authorization and benefit verification processes, ensuring timely access for patients through effective coordination with payers and providers.
- Reviewed reimbursement requirements and documented access decisions in tracking systems, improving communication and follow-up for stakeholders.
Patient Service Representative
ZOLL Lifevest
Corpus Christi, TX
02.2020 - 03.2021
- Provide post-prescription education and demonstrations to patients and caregivers on the proper use of the lifevest, disease state education, and other messaging as approved by the manufacturer.
- Provide post-prescription education and demonstrations to patients and caregivers on the proper use of the lifevest, disease state education, and other messaging as approved by the manufacturer.
- Provided product instruction in home and health care settings within 4 hours of the request.
- Coordinated training schedules with hospital case managers and healthcare providers, ensuring timely education delivery to patients.
- Collaborated with sales and reimbursement teams to improve patient service workflows, facilitating better access to necessary resources.
Field Access Manager
Synecos Health
Houston, TX
06.2016 - 10.2019
- Acquired expertise in centers of Medicare & Medicaid Services (CMS) policies and processes related to Medicare Part D, enhancing compliance and operational efficiency.
- Reviewed clinical information in patient charts and interpreted payer policy to guide HCP offices in completing prior authorization, formulary exception, and appeals documentation, ensuring timely patient access to necessary treatments.
- Collaborated with multiple departments to streamline processes and enhance communication. with Amgen Pharmaceuticals Corporation, including Field Sales, Marketing, Market Access, Public Affairs, State & Government Affairs, Trade, and Specialty Pharmacy Account Management.
Senior Clinical Nurse Educator
United BioSource Corporation
Laredo, TX
07.2015 - 05.2016
- Designed, developed, and delivered client-specific product training with sales and marketing teams, enhancing understanding and application of products for patients, physicians, and health care providers.
- Collaborated with sales team to provide clinical product information, strengthening sales presentations and improving communication with local, regional, and national health care audiences.
- Ensured training materials complied with company policy, accreditation standards, and program requirements, maintaining quality and regulatory alignment.
Senior Clinical Nurse Educator (Hospital Based)
inVentiv Health
Laredo, TX
06.2013 - 05.2015
- Designed and delivered client-specific product training with sales and marketing teams, addressing needs of patients, physicians, and health care providers.
- Collaborated with sales team to provide clinical product information that strengthened sales presentations across local, regional, and national markets.
- Developed training materials in alignment with company policy, accreditation standards, and program requirements.
Education
Masters of Science - Nursing
Walden University
Minneapolis, MinnesotaSkills
- Reimbursement strategy
- Reimbursement management
- Patient access programs
- Patient access
- Prior authorization
- Benefits verification
- Payer policy review
- Coverage criteria
- CMS compliance
- Microsoft Office, CRM, Market Access Software, Patient Access Solutions
Activities and Honors
American Nurse Association, Texas Nurse Association, Case Manager Association.
Timeline
Field Access and Reimbursement Manager
Johnson & Johnson
08.2024 - Current
Field Access Manager
Synecos Health
03.2021 - 05.2024
Patient Service Representative
ZOLL Lifevest
02.2020 - 03.2021
Field Access Manager
Synecos Health
06.2016 - 10.2019
Senior Clinical Nurse Educator
United BioSource Corporation
07.2015 - 05.2016
Senior Clinical Nurse Educator (Hospital Based)
inVentiv Health
06.2013 - 05.2015
Masters of Science - Nursing
Walden University