Remote Case Manager: Pharma Benefits & Appeals

UBC; United States; À distance; USD 45 000 - 70 000; Plein temps

Avantages offerts par ce poste

Remote opportunities

Competitive salaries

Growth opportunities for promotion

401K with company match

Tuition reimbursement

Flexible work environment

20 Days PTO (Paid Time Off)

Paid Holidays

Employee assistance programs

Medical, Dental, and vision coverage

HSA/FSA

Telemedicine (Virtual doctor)

Wellness program

Adoption assistance

Short term disability

Long term disability

Life insurance

Discount programs

Résumé du poste

UBC in the United States seeks a Case Manager to oversee day-to-day caseloads, coordinating prior authorizations, reauthorizations, and appeals to ensure timely completion and accurate payer documentation.

You will assess eligibility for services, coordinate with patients, healthcare providers, and field reimbursement teams, and support program enrollment. A bachelor’s degree or equivalent experience and strong communication are required.

Qualifications

• Bachelor’s degree or six years of relevant working experience.
• Two or more years of relevant experience in pharmacy benefit management.
• Proficient in Microsoft Office applications; strong written and verbal communication.
• Knowledge of medical and claims processing terminology; ability to multi-task.

Responsabilités

• Provide day-to-day oversight and coordination of caseload to ensure timely completion of tasks.
• Serve as primary contact for prior authorizations and appeals communications with patients, providers, and stakeholders.
• Communicate patient benefits and responsibilities promptly and accurately.
• Assess and refer patients for applicable programs/services such as PAP or injection services.
• Perform quality checks on cases and report trends to leadership.
• Maintain compliance with quality, safety, and environmental programs and procedures.

Connaissances

Communication skills

Critical thinking

Multi-tasking

Medical terminology

Formation

Bachelor’s degree or six years of relevant working experience

Outils

Microsoft Office

Description du poste

UBC in the United States seeks a Case Manager to oversee day-to-day caseloads, coordinating prior authorizations, reauthorizations, and appeals to ensure timely completion and accurate payer documentation.

You will assess eligibility for services, coordinate with patients, healthcare providers, and field reimbursement teams, and support program enrollment. A bachelor’s degree or equivalent experience and strong communication are required.