Patient Access & Case Manager (Hybrid)

RareMed Solutions; Coraopolis (Allegheny County); Hybrid; USD 52,000 - 78,000; Full time

Benefits offered by this job

Hybrid work structure

Job summary

RareMed Solutions is seeking a Case Manager to serve as the primary contact for patient journeys, coordinating with program operations and management to ensure timely enrollment and access to therapies.

The role requires deep knowledge of disease states, payer processes, and reimbursement pathways, with strong communication and problem-solving skills for patients, providers, and payers.

Qualifications

• Bachelor’s Degree or 3-5 years case management or patient advocacy experience.
• 2+ years experience in a pharmacy, healthcare setting, and/or insurance background.
• Strong analytical and organizational skills with attention to detail.
• Excellent verbal and written communication skills.
• Strong reimbursement knowledge of BI/BV prescription benefits; PA authorizations, access management.

Responsibilities

• Primary point of contact for patient journey.
• Coordinates services with internal program operations and Program Management.
• Assess, plan, implement, and evaluate patient/caller needs for guidance throughout patient journey.
• Possess broad understanding of assigned disease states, products, and support programs.
• Work independently to complete assigned work per SOPs and service levels to enroll patients, answer inquiries, and coordinate access to therapies.
• Processing of patient and prescriber requests to ensure access to therapy in a timely manner.
• Collaborate with key personnel to expedite referral processing from initiation to product delivery.
• Maintain frequent phone contact to resolve inquiries with internal staff, external teams, patients, and specialty pharmacies.
• Provide exceptional customer service; escalate appropriately.
• Support payer processes, product access, and navigating prior authorization to help patients gain access.

Skills

Analytical thinking

Organizational skills

Verbal and written communication

Time management

Education

Bachelor’s Degree

Tools

CRM platform

Microsoft Excel

Job description

RareMed Solutions is seeking a Case Manager to serve as the primary contact for patient journeys, coordinating with program operations and management to ensure timely enrollment and access to therapies.

The role requires deep knowledge of disease states, payer processes, and reimbursement pathways, with strong communication and problem-solving skills for patients, providers, and payers.