Service Management Specialist II

Responsibilities

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:

Include educational requirements or equivalency, required years and type(s) of experience, and necessary licenses or certificates. Specify which are required and which are preferred.

• 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:

Describe critical skills needed to successfully perform job, which should be representative of the knowledge, skills and/or abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Prior reimbursement experience with ability to communicate complex reimbursement scenarios to patient sand 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:

List any other job requirements, including domestic travel, international travel, driver’s license, physical abilities required, etc.

• Valid driver’s license

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