Case Manager II (Clinical)

Immediate need for a talented Case Manager II (Clinical). This is a 05+months contract opportunity with long-term potential and is located in Cambridge, MA(Onsite). Please review the job description below and contact me ASAP if you are interested.
 
Job ID:25-65877
 
Pay Range: $45 - $50/hour.  Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).
 
Key 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.
• Establishes and maintains 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.
• Represent at patient meetings and conferences as the trusted community resource.
• Document call details with attention to data integrity to ensure compliance and enhance our service offering.
• Leverages 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 .

Key Requirements and Technology Experience:

• Key Skills:Case Management, Reimbursement, Patient Care, Spanish.
• Ensure compliance with policies.
• 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 PowerPoint.
• Working hours may vary based on business needs and team coverage.
• Spanish language fluency highly preferred.
• This position is based in Cambridge, MA.
• Remote work available 2 days per week. Hours are 10:30am-7pm EST.

Our client is a leading Pharmaceutical Industry, and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration.
 
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