Virtual Case Manager

Description: • Serve as a patient advocate on behalf of the patient to coordinate access to medicines for timely treatment initiation, training, and ongoing shipments across HCP office, payer, and specialty pharmacy. • Understand a patient’s support needs and interaction preferences to deliver a seamless, tailored patient experience that helps each patient complete their treatment as prescribed by the HCP (Healthcare Professional). • Provide support to patients and HCPs (Health Care Professional) throughout the prior authorization and appeals processes. • Educate providers and patients on relevant payer policies to help ensure patients can start and stay on therapy. • Provide support to each assigned patient about their coverage status while maintaining accurate information in the designated computer system to support data integrity of information relayed to customers and clients. • Manage a regional caseload promptly as defined by Service Level Agreements. • Triage accounts and patient cases to aligned Field Access Lead based on business rules established by client. • Identify trends regarding reimbursement delays, patient concerns, and reports to leadership. • Communicate with assigned patients, e.g., patient insurance benefit information, available out-of-pocket support, etc. • Communicate with Field Access Lead regarding patient updates, missing information, and delivery of benefits. • Collaborate with targeted providers and pharmacies by following up to ensure prescriptions are being processed. • Help ensure patients have access to all information, by compliantly navigating payer reimbursement, and mitigating any patient out-of-pocket barriers, as applicable. • Educate on and enroll patients in Patient Support Programs. • Provide coverage by answering inbound calls from providers, clients, patients, care givers, and pharmacies when applicable. • Follow all requirements associated with compliance with program regulations, including HIPAA (Health Insurance Portability and Accountability) and patient privacy. Requirements: • Bachelor’s degree required • Minimum 1-2 years of industry experience with pharmaceutical or healthcare case management and knowledge of medical or pharmaceutical terminology. • Experience with health insurance and Rx reimbursement. • Understand HIPAA and privacy laws and requirements and maintain patient confidentiality • Experience with Adverse Event and Product Quality Complaint reporting • Maintain compliance with program business rules, standard operating procedures, and guidelines • Outstanding case management is required • Passionate about learning and able to share/communicate that passion to others • Exhibit collaboration and follow up is necessary • You must demonstrate the ability to work in a dynamic and culturally diverse workplace. Benefits: • Excellent Benefits – accrued time off, medical, dental, vision, 401k, disability & life insurance, paid maternity and bonding time benefits, employee discounts/promotions • Generous performance-driven Incentive Compensation package • Competitive environment with company wide recognition, contests, and coveted awards • Exceptional company culture • Recognized as a Top Workplace USA 2021 • Awarded a “Great Place to Work” award in 2022 and 2023 Fortune Best Workplaces in Biopharma 2022 Apply Job!