Case Manager – Rare Disease, TEPEZZA

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

📋 Description

• Oversee daily patient customer service matters related to insurance, specialty pharmacies, and patient support initiatives.

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

• Manage all necessary steps to ensure patient access to therapy, collaborating with RBMs, PALs, the hub, pharmacy, and patients/families.

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

• Keep detailed case histories and relevant notes for all U.S. patients.

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

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

• Coordinate with medical offices to secure insurance authorizations.

• Provide guidance to patients and families regarding insurance and reimbursement alternatives.

• Identify adherence patterns and recommend suitable actions.

• Report weekly updates on patient status, adjudication status, reimbursement trends, successes, and challenges.

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

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

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

⛳️ 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.

• A bachelor’s degree is strongly preferred.

• At least 5 years of experience in the pharmaceutical sector.

• Minimum of 2 years’ experience as a Case Manager.

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

• Capacity to effectively address challenges across multiple cases simultaneously.

• Willingness to learn about product and disease information.

• 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.

• Willingness to travel up to 20% of the time.

🏝️ Benefits

• Comprehensive employee benefits package.

• Retirement and Savings Plan with generous contributions from the company.

• Group medical, dental, and vision insurance coverage.

• Life and disability insurance.

• Flexible spending accounts.

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

• Stock-based long-term incentives.

• Award-winning time-off plans.

• Bi-annual company-wide shutdowns.

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

• Opportunities for career development.

• Up to 20% travel.