Yashly Garcia
Houston,TX
Summary
Dynamic Patient Engagement and Reimbursement professional, combining a decade of healthcare experience with a focus on pediatric and rare disease support. Expertise in facilitating patient access to therapies and navigating reimbursement processes, resulting in improved patient outcomes and treatment adherence. Recognized for fostering partnerships across healthcare ecosystems to optimize patient experiences.
Overview
1
1
Language
1
1
Certification
9
9
years of professional experience
Work History
Patient Engagement Lead
NS Pharma
Houston, Texas
01.2025 - Current
- Serve as the primary field-based contact for patients, caregivers, advocacy organizations, and healthcare providers supporting individuals and families affected by Duchenne Muscular Dystrophy (DMD).
- Partner with HUB case managers, specialty pharmacies, infusion providers, and healthcare practices to facilitate timely therapy initiation and continuity of care.
- Educate and Provide ongoing support and education throughout the patient journey, including updates related to access determinations, appeals, bridge programs, copay assistance, and patient assistance programs.
- Developed and maintained collaborative relationships with advocacy organizations to enhance patient awareness and improve access to resources.
- Coordinated with Patient Services, Market Access, Medical Affairs, Legal, and Commercial teams to enhance patient experiences and resolve access barriers.
- Support patients during insurance transitions, reauthorization events, and changes in treatment settings to ensure continuity of care.
Patient Experience/ Reimbursement Support Manager
Otsuka Pharmaceuticals
Newark, New Jersey
10.2021 - 01.2025
- Educated providers and clinical staff on payer requirements, prior authorization processes, appeals procedures, reimbursement pathways, and patient support programs to enhance understanding and compliance.
- Acted as a reimbursement and access resource for healthcare providers, communicating payer policies, coverage criteria, and treatment access requirements to facilitate informed decision-making.
- Partnered with healthcare providers, office staff, hospitals, and specialty pharmacies to support patient access to specialty therapies and address reimbursement barriers.
- Facilitated transition-of-care planning and access support for patients requiring specialty medications.
- Collaborated with Ecosystem Leads, Health Science Advisors, Clinical Science Liaisons, and market access teams to improve patient access outcomes.
- Worked with providers to improve prior authorization submission quality and increase approval success rates.
- Assisted offices in navigating access barriers, promoting patient-centered solutions and enhancing treatment adherence.
- Supported REMS education and compliance initiatives across provider offices and healthcare systems.
- Established pharmacy partnerships to reduce treatment delays and improve continuity of care.
Registered Nurse, Peds Cardiac Intensive Care Unit
Mount Sinai
New York, New York
08.2017 - 05.2022
- Delivered comprehensive nursing care in a high-acuity Pediatric Intensive Care Unit caring for critically ill patients with complex medical conditions.
- Managed care for patients requiring ECMO, CVVH, Berlin Heart, VAD, and open-chest postoperative interventions, ensuring optimal clinical outcomes.
- Conducted comprehensive patient assessments and administered medications while monitoring and implementing evidence-based interventions to uphold patient safety standards.
- Educated patients and families on treatment adherence and discharge planning to enhance continuity of care and improve patient understanding.
- Served as Charge Nurse overseeing staffing coordination, resource management, clinical operations, and nurse mentoring.
- Led quality improvement initiatives resulting in a greater than 50% reduction in pressure injuries.
Education
Bachelor of Science - Nursing
Northeastern University
Boston, MA08-2016
Bachelor of Science - Biology
St. John's University
Jamaica, NY05-2013
Skills
- Patient Engagement & Advocacy
- Rare Disease Patient Support
- Duchenne Muscular Dystrophy (DMD)
- Patient Access & Reimbursement
- Prior Authorizations and Reauthorizations
- Appeals & Denials Management
- Care Coordination
- Insurance verification and Navigation
- Site-of-Care Management
- Patient Assistance and Copay Program
- Medical and Pharmacy Benefits
- Buy-and-Bill Reimbursement Models
- Home Infusion Support
Certification
- Registered Nurse (RN), Texas
- Prior Authorization Certified Specialist (PACS)
- Certified Critical Care RN
Languages
Spanish
Native/ Bilingual
Timeline
Patient Engagement Lead
NS Pharma
01.2025 - Current
Patient Experience/ Reimbursement Support Manager
Otsuka Pharmaceuticals
10.2021 - 01.2025
Registered Nurse, Peds Cardiac Intensive Care Unit
Mount Sinai
08.2017 - 05.2022
Bachelor of Science - Nursing
Northeastern University
Bachelor of Science - Biology
St. John's University