Case Manager Rare Disease TEPEZZA - Memphis TN

Military Spouse Corporate Career Network•Memphis, TN

1d•Onsite

About The Position

The Case Manager supports U.S. patients receiving TEPEZZA by coordinating access to therapy and addressing insurance, specialty pharmacy, and patient support program issues. The role maintains patient case histories and status information, helps patients and families navigate reimbursement and financial assistance options, and works with internal teams, medical offices, pharmacies, and the patient support hub. The position also monitors adherence and reimbursement trends, reports case and program updates, and attends patient meetings, industry conferences, and sales meetings. Up to 20% travel is required.

Requirements

Master’s degree; or bachelor’s degree and 2 years of case management experience; or associate 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 resolve hurdles across multiple cases simultaneously.
Ability to learn product and disease information.
Familiarity with HIPAA and FDA.
Ability to manage communications with case managers and sales representatives across multiple geographies and time zones.
Excel and PowerPoint skills.
Ability to travel up to 20%.

Nice To Haves

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

Responsibilities

Monitor patient customer-service issues involving insurance, specialty pharmacies, and patient support programs.
Communicate regularly with Regional Business Managers, Patient Access Liaisons, and Medical Science Liaisons about insurance approvals and reauthorizations.
Coordinate with Regional Business Managers, Patient Access Liaisons, the hub, pharmacies, and patients or families to manage the steps needed to access therapy.
Partner with Safety and Pharmacovigilance; report adverse events and product complaints through medical information.
Maintain case histories for U.S. patients, recording relevant information from the hub, pharmacies, insurers, support programs, medical offices, patients, and families.
Update patient status and track reimbursement and shipping status.
Triage, troubleshoot, and resolve reimbursement issues, including prior authorizations, denials, appeals, reauthorizations, overrides, and billing problems.
Work with medical offices as needed to obtain insurance authorizations.
Counsel patients and families about insurance and reimbursement options.
Identify adherence trends and recommend appropriate action.
Report weekly patient-status changes, adjudication status, reimbursement trends, successes, and roadblocks.
Manage and report on annual Open Enrollment efforts to help ensure every patient has access to adequate insurance.
Advise patients and families about insurance, financial assistance, and therapeutic access programs.
Attend patient meetings, industry conferences, and sales meetings.

Benefits

Comprehensive employee benefits package.
Retirement and Savings Plan with generous company contributions.
Group medical, dental, and vision coverage.
Life and disability insurance.
Flexible spending accounts.
Discretionary annual bonus program, or a sales-based incentive plan for field sales representatives.
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.
Career development opportunities.