Remote Case Manager - Pharmacy Benefits & PAP

United Biosource Corporation; United States; Remote; USD 60,000 - 90,000; Full time

Benefits offered by this job

Remote opportunities

Growth opportunities for promotion

401K with company match

Tuition reimbursement

Flexible work environment

20 Days PTO

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

United Biosource Corporation is seeking a Case Manager to provide day-to-day case management oversight and coordination of a client caseload in a remote U.S. setting.

You will ensure prior authorizations, reauthorizations, and appeals are obtained timely, and serve as the primary resource for patients, providers, and field reimbursement teams. The role requires collaboration, accuracy in payer information, and the ability to screen for eligibility in PAP and other programs.

Qualifications

• Bachelor's degree or six years of relevant working experience.
• 2+ years of relevant PBM experience 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.
• Strong critical thinking and multi-tasking abilities.

Responsibilities

• Provide day-to-day oversight and coordination of caseload to ensure timely completion of all case elements.
• Serve as single point of contact for prior authorization and appeal communications with patients, providers, and external stakeholders.
• Communicate patient benefits and responsibilities clearly and promptly.
• Assess and refer patients for special programs/services when appropriate.
• Perform quality checks on cases and report trends to leadership.
• Maintain compliance with quality, safety and environmental programs and procedures.
• Troubleshoot complex cases across disease-states coordinating with stakeholders.
• Report Adverse Drug Events per pharmaceutical requirements.
• Identify product quality concerns and forward information to manufacturer.
• Other duties as assigned.

Skills

Written/verbal communication

Critical thinking

Multi-tasking

Healthcare knowledge

Education

Bachelor's degree

Tools

Microsoft Office

Job description

United Biosource Corporation is seeking a Case Manager to provide day-to-day case management oversight and coordination of a client caseload in a remote U.S. setting.

You will ensure prior authorizations, reauthorizations, and appeals are obtained timely, and serve as the primary resource for patients, providers, and field reimbursement teams. The role requires collaboration, accuracy in payer information, and the ability to screen for eligibility in PAP and other programs.