Case Manager - Rare Disease- TEPEZZA - Central US- Remote

Amgen•Memphis, TN

4d•$81,852 - $110,740•Remote

About The Position

The Case Manager provides day-to-day oversight of patient customer service issues involving insurance, specialty pharmacies, and patient support programs for TEPEZZA. The role coordinates with Regional Business Managers, Patient Access Liaisons, Medical Science Liaisons, the patient support hub, pharmacies, medical offices, and patients and families to help patients access therapy and maintain treatment. The Case Manager maintains patient case histories and status records, tracks reimbursement and shipping, troubleshoots insurance and reimbursement issues, and advises patients and families on insurance, financial assistance, and therapeutic access programs. The role also monitors adherence trends, reports patient status and reimbursement trends, manages annual open-enrollment efforts, and attends patient meetings, industry conferences, and sales meetings. The position is remote and requires up to 20% travel.

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 resolve hurdles across multiple cases simultaneously.
Ability to learn product and disease information and 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.
Up to 20% travel required.

Nice To Haves

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

Responsibilities

Oversee and remain aware of 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 business managers, Patient Access Liaisons, the hub, pharmacies, patients, and families to manage the steps required to gain access to 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, pharmacy, insurance calls, support programs, healthcare providers, 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.
Contact medical offices as needed to obtain insurance authorizations.
Counsel patients and families about insurance and reimbursement options.
Identify adherence trends and suggest appropriate action.
Report weekly changes in patient status, adjudication status, reimbursement trends, successes, and roadblocks.
Manage, track, and report annual open-enrollment efforts to help ensure patients have adequate insurance access.
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.
Work/life balance.