Senior Case Manager- Specialty
About The Position
As a Senior Case Manager in Patient Services, you will join a dynamic team dedicated to facilitating access to our treatments by overcoming non-clinical challenges and ensuring compliance with regulatory standards. This role involves acting as the primary liaison between patients, healthcare providers, and various partners, guiding them through the complexities of accessing prescribed medications. Your goal will be to provide empathetic, patient-focused care from the initiation to the closure of each case. Through your meticulous attention to detail and proactive communication, you will significantly contribute to our mission of caring deeply, working fearlessly, and changing lives. This position is integral to our operations, ensuring that our patients receive the support they need to access life-changing therapies.
Requirements
- A minimum of 3 years of customer service, patient services, case management, or related experience in a healthcare environment.
- Proficient in reimbursement processes, including benefit investigations and payer reimbursement policies.
- Strong knowledge of the managed care industry, including government payers.
- Demonstrated investigational and analytical skills.
- Ability to work effectively under pressure and prioritize tasks in a fast-paced environment.
- Strong interpersonal skills for patient support and education.
- Technical proficiency in Microsoft Office Products and CRM systems.
- High school degree required.
Nice To Haves
- Bilingual (English and Spanish) skills are a plus.
- Bachelor’s Degree preferred.
- Experience with process improvement and change management.
- Ability to work collaboratively in a team structure.
- Familiarity with protecting patient privacy in various work environments.
Responsibilities
- Build trusted relationships with patients and healthcare providers through proactive communication and timely execution of deliverables.
- Leverage a thorough understanding of program services to align support with the unique needs of each patient.
- Deliver personalized case management, including inbound and outbound communication with patients and HCPs regarding non-clinical access challenges.
- Provide personalized reimbursement support, including benefit investigations, prior authorization information, and financial assistance program determination.
- Conduct necessary benefits, coverage, and payer research to ensure compliance with appeal policies and timelines.
- Adhere to all standard operating procedures and departmental guidelines.
- Travel up to 20% to support program operations.
- Meet and exceed performance metrics and quality standards to achieve business objectives.
- Perform other duties as assigned.
Benefits
- Medical, Dental, Vision, & Life insurances
- Fitness & Wellness programs including a fitness reimbursement
- Short- and Long-Term Disability insurance
- A minimum of 15 days of paid vacation and an additional end-of-year shutdown time off (Dec 26-Dec 31)
- Up to 12 company paid holidays + 3 paid days off for Personal Significance
- 80 hours of sick time per calendar year
- Paid Maternity and Parental Leave benefit
- 401(k) program participation with company matched contributions
- Employee stock purchase plan
- Tuition reimbursement of up to $10,000 per calendar year
- Employee Resource Groups participation
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
