Pharma Case Manager: Patient Access & Reimbursement Remote

Amgen; Memphis (TN); Híbrido; USD 82 000 - 111 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Flexible work models

Remote work arrangements wherePossible

Resumo da oferta

Amgen in Memphis, TN is seeking a Case Manager to oversee patient access and reimbursement processes, coordinating with RBMs, PALs, MSLs, hub and pharmacy teams to secure insurance approvals and reauthorizations. The role requires strong communication, familiarity with HIPAA and FDA guidelines, and the ability to manage multiple cases across geographies.

Travel up to 20% may be required. You will counsel patients and families on insurance options and financial assistance, track case history, and

Qualificações

• Master’s degree OR Bachelor’s degree and 2 years of Case Management experience
• Associate’s degree and 6 years of Case Management experience
• High school diploma / GED and 8 years of Case Management experience
• HIPAA and FDA familiarity preferred

Responsabilidades

• Day to day oversight and awareness of patient customer service issues with insurance, the specialty pharmacy, and patient support programs.
• Daily interaction with Regional Business Managers (RBMs), Patient Access Liaison (PAL) and Medical Science Liaisons (MSLs) to ensure current and accurate communication on the status of insurance approvals and reauthorizations.
• Work closely with RBMs, PALs, the hub, pharmacy, and the patient/family to case manage all steps required to gain access to therapy.
• Partner with Safety and Pharmacovigilance (PV). Report Adverse Events (AEs) and product complaints through medical information.
• Maintain case history for all U.S. patients, entering relevant notes from the hub, the pharmacy, calls to insurance, patient support programs, physicians and nurses, and the patients and families.
• Maintain and update patient status to track reimbursement and shipping status of U.S. patients.
• Triage, troubleshoot and resolve initial and ongoing reimbursement issues (PAs, denials, appeals, reauthorizations, overrides, billing problems).
• Liaise with medical offices as necessary to obtain insurance authorizations.
• Counsel patients and family on insurance and reimbursement options.
• Identify general and specific adherence trends and suggest appropriate action.
• Report on weekly changes in patient status, current adjudication status of all patients, overall reimbursement trends, and any other trends, successes, or roadblocks.
• Manage, track, and report on Open Enrollment efforts annually to ensure every patient has access to adequate insurance.
• Advise patients and families on insurance, financial assistance and therapeutic access programs.
• Attend patient meetings, industry conferences and sales meetings.

Conhecimentos

Excellent communication skills

Multi-geo coordination

Able to manage multiple cases

Formação académica

Master’s degree

Bachelor’s degree

Associate’s degree

High school diploma/GED

Ferramentas

Excel

PowerPoint

Descrição da oferta de emprego

Amgen in Memphis, TN is seeking a Case Manager to oversee patient access and reimbursement processes, coordinating with RBMs, PALs, MSLs, hub and pharmacy teams to secure insurance approvals and reauthorizations. The role requires strong communication, familiarity with HIPAA and FDA guidelines, and the ability to manage multiple cases across geographies.

Travel up to 20% may be required. You will counsel patients and families on insurance options and financial assistance, track case history, and