Case Manager, East Coast (Remote)

Alnylam Pharmaceuticals

260d • Remote

About The Position

We are continuing to build out our US Patient Services team to provide exceptional customer service on all levels. Reporting to a Regional Manager, the Case Manager (CM) is a non-sales regional field-based position that will be responsible for providing a smooth customer interaction from intake through supporting continued patient access to therapy by educating physicians, genetic counselors, nurses, pharmacists and ancillary staff, as well as patients, caregivers, and families to address and prevent barriers to patient access. The CM's focus will be to optimize access to Alnylam products in his/her region by understanding and addressing patient access challenges. This position requires a professional who can leverage their expertise and experience to manage access issues as patient-specific therapy is initiated and leading action plans to resolve access issues as they arise post-therapy initiation. A key component of this role is the ability to establish and deepen customer relationships through quality interactions. The CM will also utilize a regional team approach while working with numerous internal cross-functional partners such as; Patient Services team members, Market Access, Field Sales, Strategic Accounts, Patient Advocacy and Marketing to facilitate and optimize patient care while supporting Alnylam's patient-focused vision of harnessing a revolution in biology for human health®.

Requirements

• Bachelor's Degree required. Health Care/Social Work/Nursing (or related field) a plus.
• 3+ years recent case management experience in the healthcare or pharmaceutical/biotech industry. Ultra-rare disease experience a plus.
• Experience should include but not be limited to home care management, case management review, utilization review, social service support, insurance reimbursement, patient assistance programs, or billing and coding.
• Knowledge of benefit verification and prior authorization process for infused and injectable products.
• Knowledge of private payer, Medicare, and Medicaid structure, systems, and reimbursement process required.
• Experience and proficiency in working with a Customer Relationship Management System, such as Salesforce.com.
• Possess strong written and verbal communication skills, exceptional listening, critical thinking, problem solving, negotiation and mediation skills.
• Ability to navigate difficult conversations and handle sensitive issues with opposing opinions.
• Ability to work independently and manage competing priorities.
• Experience working in cross-functional teams and effective in influencing without authority.
• Desire to innovate and work in a fast-paced, flexible, and energetic environment.
• Self-starter who is highly passionate about rare disease and Alnylam's core values: Commitment to People, Innovation and Discovery, Sense of Urgency, Open Culture, and Passion for Excellence.
• Ability to travel 5%, including weekends/evenings, as needed.

Nice To Haves

• Ultra-rare disease experience.

Responsibilities

• Assess patients' needs and develop action plans that provide for the initiation and continuation of treatment with Alnylam products while coordinating the exchange of all applicable patient-related information with appropriate internal and external stakeholders.
• Develop a comprehensive understanding of the reimbursement process, billing/coding nuances, insurance plans, payer trends, financial assistance programs, patient assistance programs, and related resources.
• Assist in obtaining insurance approval for Alnylam products, and proactively plan for maintenance of coverage by working with patients and their caregivers/families, healthcare providers, insurance companies, specialty pharmacies, and Alnylam colleagues.
• Understand the resources available in their specific region, and how they can be best employed to support patient care.
• Identify complex patient-specific issues and develop and execute action plans accordingly.
• Maintain disease, reimbursement and insurance coverage expertise through continuing medical education and attendance at relevant conferences and other educational opportunities.
• Educate patients, caregivers, family members, health care providers, and others regarding insurance options and limitations, including PA and policy requirements necessary to initiate and maintain treatment, patient services' offerings and relevant disease/product information as necessary.
• Foster collaborative relationships with all internal and external customers including but not limited to Patient Education Liaisons, medical, sales, field reimbursement, corporate accounts, patient advocacy, insurance company case managers, specialty pharmacies, home health agencies, and office coordinators.
• Attend patient meetings and represent Alnylam at industry conferences, as needed.
• Ensure compliance with all corporate and industry policies in collaboration with Alnylam Legal, Regulatory and Compliance.

Benefits

• Inclusive recruitment process and equal employment opportunity.
• Environment where employees can feel that they belong and can bring their authentic selves to work.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Industry: Chemical Manufacturing
• Education Level: Bachelor's degree