Case Manager – Rare Disease

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

📋 Description

• Supervise patient customer service concerns related to insurance, specialty pharmacy, and patient support initiatives.

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

• Manage all necessary steps for patients to access therapy.

• Collaborate with Safety and Pharmacovigilance to report adverse events and product complaints.

• Maintain case histories for patients in the U.S.

• Monitor and update the status of patient reimbursements and shipping.

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

• Coordinate with medical offices to secure insurance authorizations.

• Provide counsel to patients and families regarding insurance, financial assistance, and therapeutic access programs.

• Identify adherence patterns and recommend suitable actions.

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

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

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

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

⛳️ Requirements

• A Master’s degree, or a Bachelor’s degree with 2 years of Case Management experience, or an Associate’s degree with 6 years of Case Management experience, or a high school diploma/GED with 8 years of Case Management experience.

• A minimum of 5 years of experience in the pharmaceutical sector is preferred.

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

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

• Ability to resolve challenges across multiple cases simultaneously.

• Capacity to learn product and disease-related information.

• Familiarity with HIPAA and FDA regulations.

• Skill in managing communication across various geographies and time zones.

• Proficiency in Excel and PowerPoint is required.

• Willingness to travel up to 20% as needed.

• A Bachelor’s degree is highly preferred.

🏝️ Benefits

• Comprehensive employee benefits package.

• Retirement and Savings Plan featuring generous company contributions.

• Coverage for group medical, dental, and vision.

• Life and disability insurance options.

• Flexible spending accounts available.

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

• Stock-based long-term incentives.

• Award-winning time-off plans.

• Bi-annual company-wide shutdowns.

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

• Opportunities for career development.

• Commitment to work/life balance.