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Case Manager - Rare Disease - Mid Atlantic (Remote)
About the position
Job Description HOW MIGHT YOU DEFY IMAGINATION? You’ve worked hard to become the professional you are today and are now ready to take the next step in your career. How will you put your skills, experience and passion to work toward your goals? At Amgen, our shared mission—to serve patients—drives all that we do. It is key to our becoming one of the world’s leading biotechnology companies, reaching over 10 million patients worldwide. Come do your best work alongside other innovative, driven professionals in this meaningful role. Live What you will do Let’s do this. Let’s change the world. In this vital role the Case Manager will experience day to day oversight and awareness of patient customer service issues with insurance, the specialty pharmacy, and patient support programs Daily interaction with Regional Business Managers (RBMs), Patient Access Liaison (PAL) and Medical Science Liaison’s (MSLs) to ensure current and accurate communication on the status of insurance approvals and reauthorizations Work closely with RBMs, PALs, the hub, pharmacy, and the patient/family to case manage all steps required to gain access to therapy Partner with Safety and Pharmacovigilance (PV). Report Adverse Event (AE)’s and product complaints through medical information Maintain case history for all U.S. patients, entering relevant notes from the hub, the pharmacy, calls to insurance, patient support programs, physicians and nurses, and the patients and families Maintain and update patient status to track reimbursement and shipping status of U.S. patients Triage, troubleshoot and resolve initial and ongoing reimbursement issues (PAs, denials, appeals, reauthorizations, overrides, billing problems) Liaise with medical offices as necessary to obtain insurance authorizations Counsel patients and family on insurance and reimbursement options Identify general and specific adherence trends and suggest appropriate action Report on weekly changes in patient status, current adjudication status of all patients, overall reimbursement trends, and any other trends, successes, or roadblocks Manage, track, and report on Open Enrollment efforts annually to ensure every patient has access to adequate insurance Advise patients and families on insurance, financial assistance and therapeutic access programs Attend patient meetings, industry conferences and sales meetings Win What we expect of you We are all different, yet we all use our unique contributions to serve patients. The professional we seek is a [type of person] with these qualifications.
Responsibilities
- day to day oversight and awareness of patient customer service issues with insurance, the specialty pharmacy, and patient support programs
- Daily interaction with Regional Business Managers (RBMs), Patient Access Liaison (PAL) and Medical Science Liaison’s (MSLs) to ensure current and accurate communication on the status of insurance approvals and reauthorizations
- Work closely with RBMs, PALs, the hub, pharmacy, and the patient/family to case manage all steps required to gain access to therapy
- Partner with Safety and Pharmacovigilance (PV). Report Adverse Event (AE)’s and product complaints through medical information
- Maintain case history for all U.S. patients, entering relevant notes from the hub, the pharmacy, calls to insurance, patient support programs, physicians and nurses, and the patients and families
- Maintain and update patient status to track reimbursement and shipping status of U.S. patients
- Triage, troubleshoot and resolve initial and ongoing reimbursement issues (PAs, denials, appeals, reauthorizations, overrides, billing problems)
- Liaise with medical offices as necessary to obtain insurance authorizations
- Counsel patients and family on insurance and reimbursement options
- Identify general and specific adherence trends and suggest appropriate action
- Report on weekly changes in patient status, current adjudication status of all patients, overall reimbursement trends, and any other trends, successes, or roadblocks
- Manage, track, and report on Open Enrollment efforts annually to ensure every patient has access to adequate insurance
- Advise patients and families on insurance, financial assistance and therapeutic access programs
- Attend patient meetings, industry conferences and sales meetings
Requirements
- Master’s degree OR Bachelor’s degree and 2 years of Case Management experience Or Associate’s degree and 6 years of Case Management experience Or High school diploma / GED and 8 years of Case Management experience
Nice-to-haves
- Bachelor’s Degree strongly preferred
- 5+ years of experience in the pharmaceutical industry
- 2+ years prior experience as a Case Manager
- Excellent communication skills and commitment to customer service
- Ability to effectively resolve hurdles across multiple cases at the same time
- Ability to learn product and disease information, familiarity with HIPAA and FDA
- Ability to manage communication with case managers and sales reps across multiple geographies and time zones
- Excel and PowerPoint skills
- Up to 20% travel
Benefits
- Comprehensive employee benefits package, including a Retirement and Savings Plan with generous company contributions, group medical, dental and vision coverage, life and disability insurance, and flexible spending accounts.
- A discretionary annual bonus program, or for field sales representatives, a sales-based incentive plan
- Stock-based long-term incentives
- Award-winning time-off plans and bi-annual company-wide shutdowns
- Flexible work models, including remote work arrangements, where possible
