Michele Magara, MPH, RN
Egg Harbor,NJ
Summary
An accomplished expert with 15 years of experience in the pharmaceutical sector, dedicated to achieving results. Specializes in insurance access, payer interactions, reimbursement procedures, and specialty pharmacy protocols for ultra-rare diseases. Demonstrates a track record of effective leadership and analytical prowess, prioritizing efficiency, and quality. Devoted to enhancing patient access and ultimately improving outcomes.
Overview
16
16
years of professional experience
Work History
Senior Patient & Market Access Specialist
Takeda Pharmaceuticals
01.2015 - Current
- Strategically Enhancing Patient Access: Developed and executed strategies aimed at optimizing patient access to Takeda product, Gattex
- Payer Expertise: Field subject matter expert on payer status, prior authorization requirements, patient assistance programs, and benefits investigations
- Educational Outreach: Educated healthcare professionals (HCPs) and patients on resolution options and appeals related to various challenges, including step edits, insurance changes, ICD-11 codes, payer denials, and formulary exceptions across commercial, Medicare, and Medicaid accounts
- Collaborative Problem Solving: Primary point of contact in the field, collaborating with SPP/HUB, vendors, and sales teams to resolve complex coverage, prior authorization, and reimbursement access issues for both HCPs and patients
- Key Account Management: Managed key accounts and provided education on authorization and access issues to institutions such as UPMC, UPMC Children's Hospital, CHOP Philadelphia, Jefferson, Hershey, Geisinger, and the University of Penn, encompassing both adult and pediatric cases
- Strategic Trend Analysis: Analyzed trends and recommended the creation of a quarterly roundtable for regional directors to discuss insurance, access, and unmet patient needs within the organization, reporting to PCOC leadership
- Innovative Programs: Developed and implemented a non-branded program called "SIP" to enhance hydration outcomes, distributing it to patients and through non-branded Takeda social media
- Internal Educational Initiatives: Created and implemented an internal educational development program tailored for the OAS position
- Operational Improvement: Spearheaded a special project focused on operational performance improvement, developing and delivering a curriculum vitae
- Professional Development: Shadowed the, of Therapeutic Policy & Advocacy-Neuroscience to gain valuable insights and experience
- Extensive Knowledge: Possessed deep knowledge of US regional payers, PBMs, Medicare Part B & Part D, Medicaid, PAP, and 501c3 coverage
- Product Launch Success: Successfully launched the Gattex Pediatric indication in 2019
- Role Establishment: Pioneered the launch of the OAS role at Shire in 2015
- Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy
- Obtained patient's insurance information and determined eligibility for benefits for specific services rendered.
Specialty Clinical Nurse Educator
Shire Pharmaceuticals/Publicis Touchpoint Solution
01.2014 - 01.2015
- For Vyvanse in NJ Territory: Principal field educator for Binge Eating Disorder and Vyvanse within New Jersey territory
- Clinical Education and In-Service Sessions: Conducted in-service sessions and provided education to physicians and their staff through clinically driven disease state education program focused on raising awareness about Binge Eating Disorder
- Cross-Functional Leadership: Assumed leadership role as Nurse Educator, collaborating with eight regional business managers and regional director within multi-state territory
- ICD-10 and DSM 2014 Expertise: Provided support for product education and facilitated discussions on ICD-10 designation of Binge Eating Disorder as outlined in DSM-5 (2014 edition).
Clinical Nurse Educator
Merck Pharmaceuticals/ Quintiles Commercial Group, IQVIA
01.2008 - 01.2014
- Rebif: Clinical Nurse Educator specializing in Rebif
- Comprehensive Patient Training: Led in home patient training covering self-injectable techniques
- Additionally, provided telephonic case management, conducted outbound patient adherence support, and engaged in field-based patient support
- Expert Speaker: Subject matter expert and speaker for "Talk MS Live" lecture events, as well as Nurse lecture series "CHAT" within patient service programs
- Accomplishments
- Takeda Corporate Award Recipient: Received prestigious Takeda Corporate Award, equivalent to President's Club recognition
- Promotion to Senior OAS Position: Successfully earned promotion to Senior OAS (Patient Access Specialist) position
- Ambassador Mentor Program: Acted as mentor within Ambassador Mentor Program in collaboration with Takeda's US Public Affairs Division
- Well-being Champion: Appointed to Wellbeing @Takeda initiative.
- Contributed educational and clinical expertise to help optimize training courses and boost patient learning
Education
Certificate - Insurance
Prior Authorization Certified Specialist
PACS8.2022
Master of Public Health -
The Dartmouth Institute For Health Policy & Clinical PracticeDartmouth College
Hanover, NH06.2022
Associate of Science - Nursing
Capital Health School of Nursing/Mercer County Community College
Trenton06.2005
Bachelor of Arts - Communications, Asian Studies
Seton Hall University
South Orange, NJ06.1989
Skills
- 2021 Takeda Corporate Award Recipient: Honored recipient of Takeda Corporate Award in 2021
- 15 Years of Pharmaceutical Industry Experience:
- Senior Access Specialist: promoted to Senior Access Specialist, showcasing expertise in patient access strategies
- Cross-Functional Management: Demonstrated proficiency in cross-functional management, fostering collaboration across diverse teams Excelled in optimizing performance of Hubs, SPPs (Specialty Pharmacies), and vendor partners
- Issue and Conflict Resolution: Proven ability to effectively identify and resolve issues and conflicts, ensuring smooth operations
- Critical Thinking: Applied critical thinking skills to solve complex problems and make informed decisions
- Executive Verbal & Written Communication: Possessed strong communication skills for engaging with executives through both verbal and written means
- Patient-Focused: Maintained a dedicated focus on serving the needs and well-being of patients
- Demonstrated proficiency in a range of software tools, including Salesforce, Veeva, Microsoft Office, TEAMS, WebEx, and Canvas
- Launch Experience: Contributed to successful product launches within the pharmaceutical industry, showcasing expertise in this critical area
Awards and Honors
- 2022 MPH from Dartmouth College
- 2022 PACS Certification
- 2022 USPA Ambassador Program with Public Affairs
- 2022 Appointed to Atlantic County Mental Health Advisory Board
- 2021 One Takeda Corporate Award
- 2021 Promoted to Senior position
- 2021 Preceptorship with Market Access-Policy & Priorities
- 2021 SIP Hydration Campaign - GIBU Marketing
- 2019 Flex Leadership Program- Flex Trainer, Takeda
- 2017 MVP 4th Quarter Award - Shire
- 2014 Customer Care Award - IQVIA
- 2008 Bayada Presidential Scholarship - Advanced wound care certification.
- 2005 to Present RN - Registered Professional Nurse (2005-Present)
Timeline
Senior Patient & Market Access Specialist
Takeda Pharmaceuticals
01.2015 - Current
Specialty Clinical Nurse Educator
Shire Pharmaceuticals/Publicis Touchpoint Solution
01.2014 - 01.2015
Clinical Nurse Educator
Merck Pharmaceuticals/ Quintiles Commercial Group, IQVIA
01.2008 - 01.2014
Certificate - Insurance
Prior Authorization Certified Specialist
Master of Public Health -
The Dartmouth Institute For Health Policy & Clinical PracticeDartmouth College
Associate of Science - Nursing
Capital Health School of Nursing/Mercer County Community College
Bachelor of Arts - Communications, Asian Studies
Seton Hall University
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