Case Manager – Rare Disease

Job Description: • Experience day to day oversight and awareness of patient customer service issues with insurance, the specialty pharmacy, and patient support programs • Daily interaction with Regional Business Managers (RBMs), Patient Access Liaison (PAL) and Medical Science Liaison’s (MSLs) to ensure current and accurate communication on the status of insurance approvals and reauthorizations • Work closely with RBMs, PALs, the hub, pharmacy, and the patient/family to case manage all steps required to gain access to therapy • Partner with Safety and Pharmacovigilance (PV). Report Adverse Event (AE)’s and product complaints through medical information • Maintain case history for all U.S. patients, entering relevant notes from the hub, the pharmacy, calls to insurance, patient support programs, physicians and nurses, and the patients and families • Maintain and update patient status to track reimbursement and shipping status of U.S. patients • Triage, troubleshoot and resolve initial and ongoing reimbursement issues (PAs, denials, appeals, reauthorizations, overrides, billing problems) • Liaise with medical offices as necessary to obtain insurance authorizations • Counsel patients and family on insurance and reimbursement options • Identify general and specific adherence trends and suggest appropriate action • Report on weekly changes in patient status, current adjudication status of all patients, overall reimbursement trends, and any other trends, successes, or roadblocks • Manage, track, and report on Open Enrollment efforts annually to ensure every patient has access to adequate insurance • Attend patient meetings, industry conferences and sales meetings Requirements: • Master’s degree OR Bachelor’s degree and 2 years of Case Management experience • Or Associate’s degree and 6 years of Case Management experience • Or High school diploma / GED and 8 years of Case Management experience • 5+ years of experience in the pharmaceutical industry preferred • 2+ years prior experience as a Case Manager • Excellent communication skills and commitment to customer service • Ability to effectively resolve hurdles across multiple cases at the same time • Ability to learn product and disease information, familiarity with HIPAA and FDA • Ability to manage communication with case managers and sales reps across multiple geographies and time zones • Excel and PowerPoint skills required • Up to 20% travel required Benefits: • Comprehensive employee benefits package, including a Retirement and Savings Plan with generous company contributions • group medical, dental and vision coverage • life and disability insurance • flexible spending accounts. • A discretionary annual bonus program, or for field sales representatives, a sales-based incentive plan • Stock-based long-term incentives • Award-winning time-off plans and bi-annual company-wide shutdowns • Flexible work models, including remote work arrangements, where possible