Regional Nurse Case Manager (West)

Revolution Medicines

17h•Remote

About The Position

The Nurse Case Manager (RNCM) role sits at the intersection of patient advocacy, insurance policy, and product access – making this a critical role in supporting patients who have been prescribed a Revolution Medicines’ therapy. The RNCM Team will operate in a hybrid model in close partnership with a third-party HUB responsible for intake, benefits investigation, and Customer Relationship Management (CRM) operations. RNCMs will work directly with patients, healthcare providers, insurers, field reimbursement team, and other key stakeholders to help patients understand their coverage, access the company’s patient support programs, and connect with external resources that help overcome access barriers. This regionally aligned team (Northeast, Southeast, Central, and West) will manage the launch and ongoing lifecycle of Revolution Medicines’ approved therapies using a patient centric model. This role requires a strategic, independent worker with deep expertise in oncology market access, clinical knowledge, and a passion for ensuring no patient is left behind. By acting as a single point of contact, the RNCM will proactively manage and work individual patient cases to ensure access and financial barriers are compliantly overcome —including benefit verifications, Prior Authorization (PA) delays, denials, appeals hurdles, specialty pharmacy (SP) and non-commercial pharmacy routing issues, affordability barriers, complex Center for Medicare and Medicaid cases (CMS), community resources and more. Execute smooth transition of all Expanded Access Programs (EAP) patients with urgency upon FDA approval. Manage the standardized escalation frameworks with the Field Reimbursement Team (FRDs), specialty pharmacies, non-commercial pharmacy and insurance providers to ensure rapid and compliant issues of resolution. Ensure timely contact with patients and providers during each step from enrollment to closure of case, benefit verification, PA status, appeals, specialty and noncommercial pharmacy dispense and refills. Monitor all patient cases for delays or bottlenecks, ensuring immediate contact with the appropriate stakeholder (patient, healthcare provider (HCP), third party HUB, and FRD team) to ensure follow-up of unresolved cases. To include regularly scheduled meetings to address any issues. Maintain rigorous documentation standards to ensure access barriers are tracked, addressed, and compliantly resolved in alignment with a “no patient left behind” mindset. Foster a culture grounded in patient advocacy, compassion, compliance, customer centricity, urgency, and collaboration. Create and manage a “one-team” mindset with other critical access teams, including third-party hub provider, non-commercial pharmacy, third-party copay provider, FRD Team, Medical, Quality Control, and Patient Access leadership. Travel as needed to home office as applicable and external meetings and conferences. Other duties as assigned.

Requirements

Bachelor’s Registered Nurse degree required with current state license.
7 to 9+ years of experience in oncology, Patient Access, market access, or pharmaceutical patient service programs.
Proven experience supporting specialty or oral oncology launches (start-up or high-growth environments strongly preferred).
Deep understanding of payer dynamics, specialty pharmacy and distribution models, reimbursement processes, and patient support program operations.
Exceptional skills in communication, compliant documentation, and cross-functional collaboration.
Extensive knowledge of HIPPA regulations and Adverse Event (AE) reporting.

Nice To Haves

Advance degree (MSN, MBA, MHA, other).
Launch and customer-facing experience.
Experience with targeted oncology product experience strongly preferred.
Experience in a smaller, rapidly growing company preferred.

Responsibilities

By acting as a single point of contact, the RNCM will proactively manage and work individual patient cases to ensure access and financial barriers are compliantly overcome —including benefit verifications, Prior Authorization (PA) delays, denials, appeals hurdles, specialty pharmacy (SP) and non-commercial pharmacy routing issues, affordability barriers, complex Center for Medicare and Medicaid cases (CMS), community resources and more.
Execute smooth transition of all Expanded Access Programs (EAP) patients with urgency upon FDA approval.
Manage the standardized escalation frameworks with the Field Reimbursement Team (FRDs), specialty pharmacies, non-commercial pharmacy and insurance providers to ensure rapid and compliant issues of resolution.
Ensure timely contact with patients and providers during each step from enrollment to closure of case, benefit verification, PA status, appeals, specialty and noncommercial pharmacy dispense and refills.
Monitor all patient cases for delays or bottlenecks, ensuring immediate contact with the appropriate stakeholder (patient, healthcare provider (HCP), third party HUB, and FRD team) to ensure follow-up of unresolved cases. To include regularly scheduled meetings to address any issues.
Maintain rigorous documentation standards to ensure access barriers are tracked, addressed, and compliantly resolved in alignment with a “no patient left behind” mindset.
Foster a culture grounded in patient advocacy, compassion, compliance, customer centricity, urgency, and collaboration.
Create and manage a “one-team” mindset with other critical access teams, including third-party hub provider, non-commercial pharmacy, third-party copay provider, FRD Team, Medical, Quality Control, and Patient Access leadership.
Travel as needed to home office as applicable and external meetings and conferences.
Other duties as assigned.