Senior Case Manager, Patient Services

Biogen; Honolulu (HI); Hybrid; USD 80,000 - 110,000; Full time

Job summary

Biogen is seeking a Senior Case Manager, Patient Services to educate customers and help them access treatments by navigating benefits and approvals, ensuring safety and regulatory compliance. The role acts as liaison between patients, healthcare providers, and partners, from case initiation to closure.

The position requires strong interpersonal skills, reimbursement expertise, ability to work in a hybrid environment, up to 20% travel, and a commitment to Biogen's inclusive culture and

Qualifications

• Minimum of 3 years in customer service, patient services, or case management in healthcare.
• Proficient in reimbursement processes and payer policies.
• Knowledge of managed care, government payers, and procurement.
• Strong investigative and analytical skills.
• Ability to educate patients and providers on program options."
• Work well under pressure and manage priorities.
• Hybrid work with travel up to 20%.

Responsibilities

• Build trusted relationships with patients and healthcare providers through proactive communication.
• Deliver personalized case management including inbound and outbound communication.
• Provide personalized reimbursement support and determine financial qualifications.
• Conduct benefits, coverage, and payer research to ensure compliance.
• Meet and exceed performance metrics and quality standards.
• Adhere to SOPs and travel up to 20%.

Skills

Case management

Customer service

Interpersonal skills

Reimbursement policies

Time management

CRM software

Microsoft Office

Bilingual

Education

High school diploma

Bachelor's degree preferred

Tools

CRM software

Job description

Position Summary

The Senior Case Manager, Patient Services will educate customers about our products, to provide services that facilitate access to our treatments through the removal of non‑clinical challenges to ensure safety and compliance with FDA and other regulatory standards. Biogen values team players who are accountable, customer focused, ethical, inclusive, and agile in the ways they work. Our goal is to Care Deeply, Work Fearlessly, and Change Lives. The Senior Case Manager is responsible for acting as a liaison between patients and healthcare providers, as well as other internal and external partners by helping them navigate the complex process to supporting access to prescribed medication. The Senior Case Manager role will require a high level of ownership, problem solving, and empathetic patient focused care from case initiation to case closure. Additionally, this role will utilize strong interpersonal skills for the support and education of patients in their disease state, understanding of medical and pharmacy benefits, Biogen product education and the offering of service option explanations.

Primary Responsibilities

• Build trusted relationships with patients and healthcare providers, internal work group partners through proactive communication, timely and accurate execution of deliverables and demonstrated relentless passion for helping patients.
• Leverage thorough understanding of program services to align support provided based on the unique needs of each patient.
• Deliver personalized case management to patients and Healthcare Providers including inbound and outbound communication to patients and HCP’s regarding solutions to non‑clinical challenges to access therapy.
• Provide personalized reimbursement support to patients, healthcare providers and Biogen field support including benefit investigations, prior authorization information, denial appeals, determining financial qualifications for assistance programs and assisting patients, healthcare providers or other stakeholders through resolution by using critical thinking skills and knowledge of the program services, coverage and industry rules and standards.
• Conduct necessary benefits, coverage, and payer research/investigations to ensure appropriate resources, compliance with payer appeal policies, practices, and timelines.
• Adhere to all standard operating procedures and departmental procedures.
• Ability to travel up to 20%.
• Meet and exceed performance metrics and quality standards to ensure desired customer experience and business objectives are achieved.
• Other duties as assigned.

Competencies Critical to the Role

• Strong interpersonal skills; listens well; expresses ideas fluently and logically and is open to input.
• Professional telephone etiquette; effective verbal and written communication skills.
• Service oriented; anticipates, recognizes, and meets the needs of others, including patients, providers, field‑based team members, peers and other stakeholders.
• Pursues goals persistently despite obstacles and setbacks, achieves results.
• Persuades and influences without authority; fosters an exchange of ideas and support.
• Detail oriented, accurate and complete; investigational and problem‑solving skills.
• Ability to manage time appropriately and have strong organization skillset.
• Understanding of Standard Operating Procedures and adaptive, energetic, and comfortable with process improvement and change management.
• Ability to identify trends in assigned work and proactively communicates to leadership and partners.

Qualifications

Required Skills:

• A minimum of 3 years of customer service, patient services, case management, or related experience in healthcare environment preferred.
• Proficient in all aspects of reimbursement (i.e., benefit investigations, payer reimbursement policies, regulatory and administrative rules) and understands how to access these reimbursement and funding resources.
• Must have excellent knowledge of the managed care industry, including government payers and procurement.
• Demonstrated investigational and analytical skills.
• Ability to utilize strong interpersonal skills that will allow for the support and education of patients, understanding of medical benefits, and communicating support program options that will drive successful outcomes for patients.
• Work effectively under pressure and prioritize tasks in a fast‑paced environment.
• Ability to work collaboratively in a team structure with a desire to work with and assist peers, prescribers, sales team members, patients, and business partners.
• Ability to assist peers as needed in order to maintain performance within the team and meet the needs of the customer.
• Technical proficiency in Microsoft Office Products and CRM or equivalent system.
• Successful completion of paid training without interruption is a must.
• Bilingual (English and Spanish) skill is a plus.
• Requirement to support program operations during holidays and shutdown based on business need.
• Hybrid Role: candidate has the ability to work from home or in office as required.
• Candidate has the ability to protect patient privacy in a home, work environment.
• Candidate must meet/exceed performance metrics to be eligible to work from home.
• Candidate must have a distraction free environment in order to be eligible to work from home.

Education

High school degree required; Bachelor’s Degree preferred.

Additional Information

We are a global team with a commitment to excellence, and a pioneering spirit. As a mid‑sized biotechnology company, we provide the stability and resources of a well‑established business while fostering an environment where individual contributions make a significant impact. Our team encompasses some of the most talented and passionate achievers who have unparalleled opportunities for learning, growth, and expanding their skills. Above all, we work together to deliver life‑changing medicines, with every role playing a vital part in our mission. Caring Deeply. Achieving Excellence. Changing Lives. At Biogen, we are committed to building on our culture of inclusion and belonging that reflects the communities where we operate and the patients we serve. We know that diverse backgrounds, cultures, and perspectives make us a stronger and more innovative company, and we are focused on building teams where every employee feels empowered and inspired. Read on to learn more about our DE&I efforts.

Equal Employment Opportunity

All qualified applicants will receive consideration for employment without regard to sex, gender identity or expression, sexual orientation, marital status, race, color, national origin, ancestry, ethnicity, religion, age, veteran status, disability, genetic information or any other basis protected by federal, state or local law. Biogen is an E‑Verify Employer in the United States.

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