Case Manager Job in Massachusetts 02421, Massachusetts Us

Primary Role:
Works in a highly visible, strong team environment to provide exceptional customer service on all levels. Specifically,
listen to and counsel patients and medical professionals, interpreting their specific needs and providing friendly,
professional and well-informed answers to their questions. Case Managers will work with patients, physician offices,
partners and insurance companies to case manage all steps required to gain access to therapy. Maintain relationship
with patients and physicians to ensure ongoing compliance with therapy.

Responsibilities:
Works closely with patient/family to case manage all steps required to gain access to therapy.
 Acts as the liaison with medical offices
 Work with Specialty Pharmacy and insurance companies to obtain reimbursement information
 Perform insurance verifications with insurance companies as required.
 Locate and coordinate infusion sites for patients as required
 Counsel patient/family on reimbursement options
 Manage patient transition to home therapy. Work with partners to determine insurance benefits, locate
nursing agencies and coordinate DME.
 Responsible for maintaining case history for all assigned patients in the CRM system
 Trouble shoot and resolve ongoing reimbursement issues (lifetime caps, insurance changes, PA's, etc)
 Partner with Field Sales Reps to manage all patient cases within their assigned territories
 Professionally field incoming telephone calls while making a positive impression
 Answer patient and medical office inquiries and resolve customer problems
 Provide ongoing persistency and compliance support by making regular calls to patient/families
 Manage patient assistance requests and work with partners to process applications
 Provide back-up coverage for other Customer Service Case Managers
 Attend patient meetings and represent Shire HGT at industry conferences
 Travel to sales meetings and medical offices as necessary

Requirements:
BA/BS in the life sciences or communications preferred
 3 -5 years of prior case management experience preferred
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

Complexity Problem Solving:
Ability to problem solve complex reimbursement scenarios and recommend solutions
 Ability to maintain composure and remain professional during difficult patient or medical calls

Internal External Contacts:
Liaison with patients and families
Liaison with physicians and sites of care
Work with specialty pharmacy partners, insurance companies and nursing agencies
Work with Regional Business Managers, Patient Access Manager and Managed Care/Government Accounts team

10% Travel

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