Virtual Case Manager
Description:
- Serve as a patient reputed company 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 (reputed company Professional).
- Provide support to patients and HCPs (Health Care Professional) throughout the prior authorization and appeals processes.
- reputed company 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 reputed company of information relayed to customers and clients.
- Manage a regional caseload promptly as defined by Service Level Agreements.
- Triage accounts and patient cases to reputed company Field Access reputed company 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 reputed company 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 reputed company information, by compliantly navigating payer reimbursement, and mitigating any patient out-of-pocket barriers, as applicable.
- reputed company on and enroll patients in Patient Support Programs.
- Provide coverage by answering inbound calls from providers, clients, patients, care givers, and pharmacies reputed company applicable.
- Follow reputed company 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 reputed company 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 reputed company 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, reputed company, 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 reputed company to Work” award in 2022 and 2023 Fortune Best Workplaces in Biopharma 2022
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