Job Level
JuniorMid-Level
About the role
- Work closely with patient/caregiver to support access to therapy
- Provide day-to-day oversight and coordination of caseload to ensure timely completion of activities and tasks
- Accurately document and maintain case history for all assigned patients
- Act as single point of contact performing preliminary benefits investigations, prior authorization and appeal support
- Communicate patient benefits and responsibility timely and accurately to patients and healthcare providers
- Complete a pre-screen to determine eligibility for financial support
- Troubleshoot complex cases while interfacing with internal and external stakeholders to ensure optimal start to therapy
- Professionally field incoming telephone calls and answer patient and medical office inquiries
- Provide ongoing adherence and compliance support for patients
- Provide back-up coverage for other Case Managers
- Attend patient and commercial strategy meetings where applicable
- Ensure compliance with legal and regulatory mandates and serve as a compliance role model
Requirements
- BA/BS Preferred
- Must have a minimum of 2 years working with patient support programs
- 3-5 years of prior case management experience preferred
- 2 or more years of relevant experience in pharmacy, medical and buy & bill benefit management preferred
- Ability to perform preliminary benefits investigations, prior authorization and appeal support
- Ability to accurately document and maintain case history for assigned patients
- Ability to professionally field incoming telephone calls and communicate with patients and medical offices
- Ability to complete pre-screen to determine eligibility for financial support
- Ability to troubleshoot complex cases and interface with internal and external stakeholders
- Understanding of compliance with US Food, Drug and Cosmetic Act, U.S. anti-kickback laws, and the US PhRMA Code
- High character, strong ethics, and emotional intelligence; passion for rare disease and patient-focused