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Case Manager
2 months ago
My name is Shannon, and I am a Recruiter with The Fountain Group. We are a national staffing firm and are currently seeking a Case Manager – Patient Services for a prominent client of ours. This position is located in Cambridge, MA Details for the position are as follows:
Job Description:
As a Patient Support Specialist, you will provide exceptional service to support patients and families starting and continuing therapy by demonstrating empathetic listening skills, care, and commitment. You will coordinate between patients, healthcare providers, insurance providers, specialty pharmacies, and local resources to ensure a seamless patient experience. Your role includes conducting benefit investigations, providing patient education, enrolling in patient support programs, and coordinating drug delivery. You will excel in delivering a positive patient experience and become the resource of choice for the rare blood community. Additionally, you will be an active cross-functional team member, delivering best-in-class services to ensure patient access to therapy.
Key Responsibilities:
- Engage patients and families to build long-term relationships, uncover patient needs, understand challenges, and provide education and support to start or continue therapy.
- Manage complex issues by utilizing approved resources to reduce or remove barriers as needed.
- Assist in obtaining insurance approval for therapy, and proactively plan for maintenance of coverage by working with patients, families, healthcare providers, insurance companies, and specialty pharmacies.
- Enroll patients in financial assistance or gap coverage programs as needed.
- Educate patients, families, and healthcare providers about patient support services, insurance options, limitations, and requirements.
- Connect patients and families with local resources and support services.
- Ensure close cross-functional collaboration with Patient Services field teams, Sales, and Market Access to support patient access.
- Establish and maintain professional relationships with internal and external stakeholders, including 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 Sanofi at patient meetings and conferences as a trusted community resource.
- Document call details accurately to ensure compliance and enhance service offerings.
- Utilize CRM reporting tools and data analytics to make strategic decisions about territory management and prioritize patient and customer needs.
- Provide caseload coverage outside of the assigned territory as needed.
- Seek coaching feedback to continuously enhance service skills.
- Ensure compliance with Sanofi policies.
Qualifications:
- Bachelor’s degree required.
- Minimum of 2-4 years of patient-facing experience in case management, reimbursement, or patient advocacy.
- Experience engaging patients and caregivers with rare or chronic conditions.
- Comprehensive understanding of the reimbursement process, billing and coding, insurance plans, payer trends, financial assistance programs, and related resources.
- Excellent phone communication skills and a service-oriented mindset.
- Exceptional attention to detail and ability to multi-task in a fast-paced environment.
- Experience with Salesforce CRM preferred.
- Proficiency in MS Word, MS Excel, and MS PowerPoint.
- Working hours may vary based on business needs and team coverage.
- Spanish language fluency highly preferred.
If you are interested in hearing more about the position please respond to this posting with your resume attached
