Remote Case Manager — Pharma Benefits & Patient Support

UBC; United States; Remote; USD 50,000 - 70,000; Full time

Benefits offered by this job

Remote opportunities

Growth opportunities for promotion

401K with company match

Tuition reimbursement Flexible work环境

20 Days PTO (Paid Time Off)

Paid Holidays

Employee assistance programs

Medical, Dental, and vision coverage

HSA/FSA

Wellness program

Adoption assistance

Short term disability

Long term disability

Life insurance

Discount programs

Job summary

UBC is seeking a Case Manager to provide day-to-day case management oversight for a caseload, ensuring timely task completion and serving as the primary contact for prior authorizations, appeals, and payer coordination. This role supports patients, healthcare providers, and field reimbursement with a focus on accurate documentation and timely service delivery.

The position involves pre-screening for eligibility in additional services such as injection services, co-pay mitigation, and PAP

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.
• Act as single point of contact for prior authorization and appeal processing communications to patients, providers, field reimbursement reps and external stakeholders.
• Communicate patient benefits and responsibility timely and accurately.
• Assess and refer patients for special programs/services when appropriate.
• Perform quality checks on cases and report trends to leadership.
• Maintain good housekeeping practices and comply with safety and environmental programs and procedures.
• Troubleshoot complex cases across multiple disease states with key stakeholders.
• Report Adverse Drug Events per pharmaceutical requirements.
• Recognize product quality complaints and forward information to manufacturers.
• Perform additional duties as assigned.

Skills

Communication skills

Microsoft Office

Medical terminology

Critical thinking

Multitasking

Patient communication

Education

Bachelor's degree or six years of relevant working experience

Certification preferred

Tools

Microsoft Office

Job description

UBC is seeking a Case Manager to provide day-to-day case management oversight for a caseload, ensuring timely task completion and serving as the primary contact for prior authorizations, appeals, and payer coordination. This role supports patients, healthcare providers, and field reimbursement with a focus on accurate documentation and timely service delivery.

The position involves pre-screening for eligibility in additional services such as injection services, co-pay mitigation, and PAP