Case Manager Job Cambridge Massachusetts USA,Healthcare

My name is Minakshi and I'm working on Case Manager II in Cambridge, MA with our pharma client. Please find the Job description below and let us know if you are interested.

Title: Case Manager

Location: Cambridge, MA

JOB DESCRIPTION:

Possibility for extension

Hybrid, Remote work available 2 days per week. Hours are 10:30am-7pm EST

Paid parking is required

Minimum Requirements:

Open to all areas of study for bachelor’s degree

Minimum 2+ years of experience

Must have strong patient-facing experience (phone), role will not meet with patients in person

Must have pharma, hospital, or insurance industry experience

Must have experience with insurance and reimbursement

Job Purpose:

Provide exceptional service to support patients/families starting and continuing therapy by demonstrating empathetic listening skills, care, and commitment. Coordinate between patients/families, healthcare providers, insurance providers, specialty pharmacy, and local resources. Conduct benefit investigation, provide patient education, enroll in patient support programs, and coordinate drug delivery. Exceed in delivering a positive patient experience and be the resource of choice for the rare blood community.

Be an active cross-functional team member to deliver best-in-class services to ensure access to therapy.

Job Responsibilities:

Engage patients/families to create a long-term relationship, uncover patient needs, understand challenges, and provide education and support to start or continue therapy. Manage complex issues and utilize approved resources to reduce/remove barriers as needed.

Assist in obtaining insurance approval for therapy, proactively plans for maintenance of coverage by working with the patients/families, healthcare providers, insurance companies, and specialty pharmacies.

Enroll patients who qualify in financial assistance or gap coverage.

Educate patients/families and healthcare providers about patient support services. Educate about patient insurance options, limitations, requirements. Connect patients/families with local resources.

Ensure close cross-functional collaboration with Patient Services field teams, Sales, and Market Access as appropriate to ensure consistent integrated approach to supporting patient access.

Establish and maintain professional and effective relationships with all internal and external customers including but not limited to Patient Services colleagues, Medical, Sales, Market Access, Patient Advocacy, insurance company case managers, specialty pharmacies, home health agencies, infusion site staff, and office coordinators.

Document call details with attention to data integrity to ensure compliance and enhance our service offering.

Leverage CRM reporting tools and data analytics to make strategic decisions about their territory and prioritize patient and customer needs.

Provide caseload coverage outside of assigned territory as needed.

Seek coaching feedback to enhance service skills.

Ensure compliance with company policies.

Qualifications:

Bachelor's degree required

Minimum 2-4 years patient-facing role experience in case management, reimbursement, or patient advocacy

Experience with engaging patients and caregivers with rare/chronic conditions

Comprehensive understanding of the reimbursement process, billing/coding, insurance plans, payer trends, financial assistance programs, charitable access, and related resources

Excellent phone communication and service-oriented mindset

Excellent attention to detail and ability to multi-task in a fast-paced environment

Experience with Salesforce CRM preferred

Proficient with MS Word, MS Excel, and MS Power Point

Working hours may vary based on business needs and team coverage

This position is based in Cambridge, MA. Remote work available 2 days per week. Hours are 10:30am-7pm EST.