Case Manager – Rare Disease

This is a fully remote position, open to applicants in Arizona.

📋 Description

• Supervise and maintain awareness of customer service issues related to patients, insurance, specialty pharmacy, and patient support initiatives.

• Engage daily with Regional Business Managers, Patient Access Liaisons, and Medical Science Liaisons concerning insurance approvals and reauthorizations.

• Manage all steps necessary for patient access to therapy in collaboration with RBMs, PALs, the hub, pharmacies, and patients/families.

• Collaborate with Safety and Pharmacovigilance to report adverse events and product complaints via medical information channels.

• Keep detailed case histories for all U.S. patients, including pertinent notes from hubs, pharmacies, insurers, support programs, medical offices, nurses, patients, and families.

• Update and maintain patient status to monitor reimbursement and shipping progress.

• Triage, troubleshoot, and resolve reimbursement challenges, including prior authorizations, denials, appeals, reauthorizations, overrides, and billing issues.

• Coordinate with medical offices to secure insurance authorizations.

• Provide counseling to patients and families on insurance and reimbursement options.

• Recognize adherence trends and recommend appropriate actions.

• Report weekly on changes in patient status, adjudication updates, reimbursement trends, successes, and obstacles.

• Oversee, track, and report on annual Open Enrollment activities.

• Advise patients and families on insurance, financial aid, and access to therapeutic programs.

• Participate in patient meetings, industry conferences, and sales gatherings.

⛳️ Requirements

• Master’s degree OR Bachelor’s degree with 2 years of Case Management experience OR Associate’s degree with 6 years of Case Management experience OR High school diploma / GED with 8 years of Case Management experience.

• Bachelor’s Degree is strongly preferred.

• More than 5 years of experience in the pharmaceutical sector.

• At least 2 years of prior experience as a Case Manager.

• Exceptional communication abilities and a strong commitment to customer service.

• Capability to effectively address challenges across multiple cases concurrently.

• Ability to acquire product and disease knowledge.

• Knowledge of HIPAA and FDA regulations.

• Proficiency in managing communication with case managers and sales representatives across various geographies and time zones.

• Proficient in Excel and PowerPoint.

• Up to 20% travel may be required.

🏝️ Benefits

• Comprehensive employee benefits package.

• Retirement and Savings Plan with substantial company contributions.

• Group medical, dental, and vision coverage.

• Life and disability insurance.

• Flexible spending accounts.

• Discretionary annual bonus program, or for field sales representatives, a sales-based incentive plan.

• Stock-based long-term incentives.

• Award-winning time-off policies.

• Bi-annual company-wide shutdowns.

• Flexible work arrangements, including remote work options, where feasible.

• Opportunities for career development.

• Focus on work/life balance.