Case Manager

Aequor; Cambridge (MA); Hybrid; USD 60,000 - 90,000; Full time

Benefits offered by this job

Paid parking

Remote work available 2 days per week

Job summary

An established industry player is seeking a dedicated Case Manager to provide exceptional support to patients and their families. In this hybrid role, you will engage with patients, coordinate with healthcare providers, and ensure they receive the necessary resources and education to continue their therapy. Your empathetic listening skills and strong patient-facing experience will be crucial in managing complex issues and building long-term relationships. Join a forward-thinking team that values collaboration and strives to deliver best-in-class services, making a significant impact on the lives of patients with rare conditions.

Qualifications

• Bachelor's degree required with 2-4 years experience in patient-facing roles.
• Strong understanding of reimbursement processes and excellent communication skills.

Responsibilities

• Engage patients and families to create long-term relationships and provide support.
• Assist in obtaining insurance approval and educate patients about options.

Skills

Patient-facing experience

Communication skills

Attention to detail

Multi-tasking

Empathetic listening

Education

Bachelor's degree

Tools

Salesforce CRM

MS Word

MS Excel

MS PowerPoint

Job description

My name is Minakshi and I'm working on Case Manager II in Cambridge, MA with our pharma client. Please find the Job description below and let us know if you are interested.

Title: Case Manager

Location: Cambridge, MA

JOB DESCRIPTION:

Possibility for extension

Hybrid, Remote work available 2 days per week. Hours are 10:30am-7pm EST

Paid parking is required

Minimum Requirements:

1. Open to all areas of study for bachelor’s degree
2. Minimum 2+ years of experience
3. Must have strong patient-facing experience (phone), role will not meet with patients in person
4. Must have pharma, hospital, or insurance industry experience
5. Must have experience with insurance and reimbursement

Job Purpose:

Provide exceptional service to support patients/families starting and continuing therapy by demonstrating empathetic listening skills, care, and commitment. Coordinate between patients/families, healthcare providers, insurance providers, specialty pharmacy, and local resources. Conduct benefit investigation, provide patient education, enroll in patient support programs, and coordinate drug delivery. Exceed in delivering a positive patient experience and be the resource of choice for the rare blood community. Be an active cross-functional team member to deliver best-in-class services to ensure access to therapy.

Job Responsibilities:

1. Engage patients/families to create a long-term relationship, uncover patient needs, understand challenges, and provide education and support to start or continue therapy. Manage complex issues and utilize approved resources to reduce/remove barriers as needed.
2. Assist in obtaining insurance approval for therapy, proactively plans for maintenance of coverage by working with the patients/families, healthcare providers, insurance companies, and specialty pharmacies.
3. Enroll patients who qualify in financial assistance or gap coverage.
4. Educate patients/families and healthcare providers about patient support services. Educate about patient insurance options, limitations, requirements. Connect patients/families with local resources.
5. Ensure close cross-functional collaboration with Patient Services field teams, Sales, and Market Access as appropriate to ensure consistent integrated approach to supporting patient access.
6. Establish and maintain professional and effective relationships with all internal and external customers including but not limited to Patient Services colleagues, Medical, Sales, Market Access, Patient Advocacy, insurance company case managers, specialty pharmacies, home health agencies, infusion site staff, and office coordinators.
7. Document call details with attention to data integrity to ensure compliance and enhance our service offering.
8. Leverage CRM reporting tools and data analytics to make strategic decisions about their territory and prioritize patient and customer needs.
9. Provide caseload coverage outside of assigned territory as needed.
10. Seek coaching feedback to enhance service skills.
11. Ensure compliance with company policies.

Qualifications:

1. Bachelor's degree required
2. Minimum 2-4 years patient-facing role experience in case management, reimbursement, or patient advocacy
3. Experience with engaging patients and caregivers with rare/chronic conditions
4. Comprehensive understanding of the reimbursement process, billing/coding, insurance plans, payer trends, financial assistance programs, charitable access, and related resources
5. Excellent phone communication and service-oriented mindset
6. Excellent attention to detail and ability to multi-task in a fast-paced environment
7. Experience with Salesforce CRM preferred
8. Proficient with MS Word, MS Excel, and MS PowerPoint
9. Working hours may vary based on business needs and team coverage

This position is based in Cambridge, MA. Remote work available 2 days per week. Hours are 10:30am-7pm EST.