Service Management Specialist II

LanceSoft Inc; Lexington (MA); On-site; USD 70,000 - 90,000; Full time

Job summary

A patient advocacy organization is seeking a dedicated financial case manager to serve as a patient advocate, guiding patients through enrollment processes and managing their financial needs. The ideal candidate should possess a strong background in case management coupled with communication skills to navigate complex reimbursement scenarios. Responsibilities include collaborating with various stakeholders, managing patient records, and providing vital support to enhance patient treatment goals. Candidates with at least 5 years of relevant experience are encouraged to apply.

Qualifications

• Minimum of 5 years of prior case management experience within the last 2 years.
• Minimum of 3 years of customer service experience.

Responsibilities

• Serve as a patient advocate by communicating with 501c3 organizations.
• Counsel patient/family on reimbursement options.
• Conduct research, manage patient records, and organize documentation for patient assistance.
• Guide patients through enrollment periods with payers and organizations.
• Collaborate with Patient Services Team for patient status updates.
• Monitor patients approaching Medicare eligibility for appropriate placements.
• Coordinate and manage patient referral/enrollment into programs.
• Act as a single point of contact for enrolled patients.
• Maintain communication with patients and medical providers.
• Research programs available across all states and territories.
• Provide backup coverage for other Financial Case Managers.
• Attend patient meetings and industry conferences.
• Travel to meet patients face to face as necessary.
• Serve as an on-the-floor leader.
• Become a subject matter expert in a particular area.
• Train Sales, Marketing, and Patient Services teams.
• Manage Risk Evaluation and Mitigation Strategies (REMS) patients.
• Attend regional or national meetings related to disease states.

Skills

Prior reimbursement experience

Ability to multi-task

Problem-solving skills

Strong verbal and written communication skills

Customer Service Focus

Presentation skills

Ability to handle sensitive information

Work in a team environment

Adaptability to complex situations

Education

BS/BA in life sciences/communications

Tools

MS Office Suite

Job description

Responsibilities

Describe the essential job duties. After each, provide an estimate of the percent of time typically devoted to each responsibility (use increments of 5%, all time spent should total to 100% of time allocation). To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Please note the percentage of time spent on each job duty is an estimate for normal operating conditions.

• Serves as a patient advocate by communicating with 501c3 organizations as well as any other organizations offering services to patients in need
• Counsel patient/family on reimbursement options
• Conducts research, manage patient records, and organizes documentation for the purposes of providing patient assistance
• Guides patients through enrollment periods through both commercial and government payers as well as nonprofit organizations offering assistance
• Collaborates with other members on the Patient Services Team for the purposes of updating patient status’ currently in Financial Case Management
• Monitor and work with patients approaching Medicare eligibility to ensure appropriate placement in Parts A, B, & D plans as well as supplemental and Gap coverage where necessary
• Coordinate and manage all eligible patient referral/enrollment into the Rare Disease Financial Assistance and PAP Program
• Act as single point of contact for patients enrolled in the RDCF program to external stakeholders
• Maintain communication and interaction with patients and medical providers in order to address issues impeding optimum treatment goals
• Research available commercial and government sponsored programs across all 50 states and Puerto Rico.
• Provide back-up coverage for other Financial Case Managers
• Attend patient meetings and represent the foundation at industry conferences
• Travel to sales meetings and meet patients face to face as necessary
• Be an on the floor leader
• Become the subject matter expert for the group in a particular area (ex – Medicare, healthcare reform, etc) and present this section to new hires during training process
• Train Sales, Marketing and Patient Services
• Manage Risk Evaluation and Mitigation Strategies (REMS) patients prior to enrolling them into RCDF
• Attend regional CMSA conference or national meetings related to all disease states we support

Education & Experience Requirements:

• BS/BA in life sciences/communications is preferred
• Minimum of 5 years of prior case management experience (within last 2 years)
• Minimum of 3 years of customer service experience

Key Skills and Competencies:

• Prior reimbursement experience with ability to communicate complex reimbursement scenarios to patients and medical professionals.
• Ability to multi task, problem solve and work independently
• Individual must possess and portray strong emotional resilience
• Individual must possess extraordinary positive attitude, exceptional listening skills, and strong verbal and written communication skills
• Ability to handle sensitive information
• Ability to work in a team environment with excellent communication skills
• Presentation skills
• Proficient in all MS Programs (MS, Access, Word, Outlook, and PowerPoint)
• Customer Service Focus
• Adapts to complex situations

Other Requirements:

• Valid driver’s license

Additional Information

All your information will be kept confidential according to EEO guidelines.