Case Manager - Rare Disease - BKEMV- West Coast Remote

Amgen • Los Angeles, CA

6d • $81,852 - $110,740 • Remote

About The Position

In this vital role, the Case Manager will experience day-to-day oversight and awareness of patient customer service issues with insurance, the specialty pharmacy, and patient support programs. This role involves daily interaction with Regional Business Managers (RBMs), Patient Access Liaisons (PALs), and Medical Science Liaisons (MSLs) to ensure current and accurate communication on the status of insurance approvals and reauthorizations. The Case Manager will work closely with RBMs, PALs, the hub, pharmacy, and the patient/family to case manage all steps required to gain access to therapy. A key responsibility includes partnering with Safety and Pharmacovigilance (PV) to report Adverse Events (AEs) and product complaints through medical information. The role requires maintaining case history for all U.S. patients, entering relevant notes from various sources, and updating patient status to track reimbursement and shipping. The Case Manager will triage, troubleshoot, and resolve reimbursement issues, liaise with medical offices for authorizations, and counsel patients and families on insurance and reimbursement options. Identifying adherence trends, reporting on patient status and reimbursement trends, managing Open Enrollment efforts, and advising on financial assistance programs are also core functions. Attendance at patient meetings, industry conferences, and sales meetings is expected.

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
• 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

Nice To Haves

• Bachelor’s Degree strongly preferred
• 5+ years of experience in the pharmaceutical industry
• 2+ years prior experience as a Case Manager

Responsibilities

• 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
• Advise patients and families on insurance, financial assistance and therapeutic access programs
• Attend patient meetings, industry conferences and sales meetings

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, and 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

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level