Pharma Case Manager - Remote, Growth & Benefits

UBC; United States; Remote; USD 52,000 - 75,000; Full time

Benefits offered by this job

Remote opportunities

401K with company match

Tuition reimbursement

Flexible work environment

PTO (Paid Time Off)

Paid Holidays

Employee assistance programs

Medical, Dental, and vision coverage

Telemedicine (Virtual doctor visits)

Wellness program

Adoption assistance

Short term disability

Long term disability

Life insurance

Discount program

Job summary

UBC is seeking a Case Manager to provide day-to-day oversight and coordination of a caseload within our pharmaceutical support framework. You will ensure timely completion of case elements and serve as the primary contact for patients, providers, and field reimbursement teams.

The role involves obtaining prior authorizations, reauthorizations, and appeals, documenting payer information, and screening for eligibility for services such as injection programs, co-pay mitigation, and patient

Qualifications

• Bachelor’s degree or six years of relevant working experience.
• Two or more years of relevant experience in pharmacy benefit management preferred.
• Medical Assistant, Social Worker or Senior Reimbursement Specialist experience preferred.
• Certification preferred but not required.
• Proficient in Microsoft Office applications.
• Knowledge of medical and claims processing terminology.
• Excellent written/verbal communication to include providing clear instructions.
• Must possess a strong critical thinking skillset along with the ability to multi-task.

Responsibilities

• Provide day-to-day oversight and coordination of caseload to ensure all case elements and tasks are completed timely and ensure cases move through the process as required.
• Act as single point of contact responsible for prior authorization and appeal processing communications to patients, healthcare providers, field reimbursement representatives and other external stakeholders.
• Communicate patient benefits and responsibility timely and accurately.
• Assess and refer patients appropriately for special programs/services when appropriate.
• Performs quality checks on cases and report trends to leadership.
• Responsible for good housekeeping techniques, adhering to quality and production standards while complying with all applicable company, state and federal safety and environmental programs and procedures.
• Troubleshoot complex cases, spanning multiple disease-states, while interfacing with key stakeholders (internal/external) to ensure optimal start to therapy
• Report Adverse Drug Events that have been experienced by the patient in accordance pharmaceutical requirements.
• Recognize a product quality complaint and forward caller/written information to a manufacturer.
• Other duties, as assigned.

Skills

Multi-tasking

Communication skills

Microsoft Office

Medical terminology

Critical thinking

Attention to detail

Education

Bachelor’s degree or 6 years experience

Tools

Microsoft Office Suite

Job description

UBC is seeking a Case Manager to provide day-to-day oversight and coordination of a caseload within our pharmaceutical support framework. You will ensure timely completion of case elements and serve as the primary contact for patients, providers, and field reimbursement teams.

The role involves obtaining prior authorizations, reauthorizations, and appeals, documenting payer information, and screening for eligibility for services such as injection programs, co-pay mitigation, and patient