Case Manager, Rare Diseases - West

Recordati Rare Diseases • Bridgewater Township, NJ

211d • Hybrid

About The Position

Support Recordati Rare Disease patients and families through care coordination and case management expertise. Develop and execute personalized plans to address patient barriers to treatment. Maintain ongoing relationships with individuals, caregivers, and healthcare providers to proactively identify and address access barriers and coordinate, as necessary, with insurance providers, specialty pharmacies and local resources. Provide best-in-class patient services to ensure a positive patient experience and support Recordati Rare Diseases business priorities.

Requirements

• Bachelor's Degree required.
• 3-5 years of patient-facing, medical insurance/billing or pharma industry experience required.
• Direct experience in case management, insurance, or healthcare systems fields.
• Pharma/biotech patient services experience preferred.

Nice To Haves

• Bi-lingual; Spanish language skills preferred.

Responsibilities

• Leads the case management process, while balancing the needs of individual patients to align with the business needs/objectives of Recordati Rare Diseases Hematology Franchise.
• Assesses patients' needs and develops strategic action plans that provide for the initiation and continuation of treatment.
• Helps facilitate insurance approval for drug coverage and access.
• Educates patients, caregivers, health care providers, and others regarding insurance options or limitations, insurance requirements, case management services, and relevant disease/product information as necessary.
• Maintains comprehensive understanding of the reimbursement process, navigation of health care systems, billing/coding guidelines, insurance plans, payer trends, internal and external patient assistance programs, and related resources.
• Enroll patients who qualify into the appropriate financial assistance program as needed/required.
• Maintains up-to-date knowledge of the resources available at the regional level as well as market landscape and applies this knowledge in way that best supports patient access to therapy.
• Compliantly coordinates the exchange of patient-related information with internal and external stakeholders.
• Exhibits initiative and leadership within the cross-functional regional team. Able to consistently identify complex patient specific issues and develop action plans accordingly.
• Demonstrates accountability for action plan execution, and energetically drives for success and results.
• Establishes and maintains professional and effective relationships with all internal and external customers and stakeholders.
• Raises own performance expectations and goals to support entrepreneurial approach to the growth of the team and the business.
• Demonstrates and maintains a high level of business acumen, understands the role of the case manager and patient support services team in commercializing the business and driving initiatives to meet goals.
• Demonstrates innovation by consistently monitoring systems, processes, and potential gaps, offering new ideas and solutions to elevate the support program.
• Effectively shares reimbursement and other knowledge with Patient Solutions team members through orientation training, case studies, consultation for complex cases, and special projects as requested.
• Consistently maintains and documents accurate data, including insurance, coverage approvals, on-going coverage requirements, and all patient and provider interactions.
• Proficient in use of CRM tool to document work. Consistently leverages CRM reporting tools and data analytics to make strategic territory decisions while prioritizing patient and customer needs.
• Provide caseload coverage outside of assigned territory as needed.
• Ensure compliance with Recordati Rare Diseases Policies.
• Act in full compliance with all laws, regulations, and policies including adverse events / pharmacovigilance responsibilities.
• Perform additional duties as may be assigned.

What This Job Offers

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