Regional Patient Case Manager-Long Term Care

2 weeks ago

Coraopolis, United States RareMed Solutions Full time
Job DescriptionJob Description


**Remote Work Flexibility**


Purpose:

The Regional Patient Case Manager – Long Term Care (RPCM-LTC) is a professional client facing role responsible for various functions, including accurate and timely response to client inquiries regarding patient-specific programs, referral status or escalation, benefits verification and financial assistance counseling. The RPCM-LTC acts as a single point of contact for communication and coordination among all participants of the LTC facility health care team to ensure that the services are provided. The RPCM-LTC is responsible for providing professional, concise internal and external communication regarding case status updates, next steps in prescription processing, shipment set ups, and communication of reimbursement issues. The RPCM-LTC oversees the provision of extended, ongoing services to residents of long-term care facilities. Also, provides intensive case management in a collaborative process that includes therapy initiation, referrals to Specialty Distributors, and triages to Specialty Pharmacy or Long-Term Care Pharmacies.

Responsibilities:

  • Serve as the point of contact for regionally aligned field team related to cases identified as LTC to initiate and support therapy to residents of long-term care facilities.

  • Coordinate all LTC facility-related support and access services across all functions including patient support and welcome, benefits verification and triage to specialty pharmacy.

  • Review and add LTC profile data to capture the key information related to LTC facilities and customers.

  • Conduct initial welcome calls to LTC facility-designated champions and/or patients/caregivers informing them of available services as well as future targeted outreach to provide ongoing support.

  • Maintain frequent touchpoints through outreach to LTC providers and patients/caregivers to communicate progress throughout their journey.

  • Work independently to complete assigned work in accordance with Standard Operating Procedures and defined service levels to complete program enrollment, answer inquiries, and coordinate access to free 14-Day Supply Program, if applicable.

  • Independently and effectively identify adverse events and/or product complaints and triage as appropriate.

  • Apply defined business rules to qualify patients for manufacturer supported programs.

  • Interact and coordinate with internal program operations, including reimbursement, and program management to ensure provider and patient needs are met in addition to attending any regularly scheduled calls.

  • Provide support, education and status updates to regionally aligned field teams, LTC facility staff, patients and caregivers to ensure efficient referral processing, triaging, and shipment set ups.

  • Manage assigned territory using problem solving skills and professional judgement to independently make sound decisions for timely case resolution.

  • Ability to coordinate and collaborate with manufacturer representatives, LTC facilities and other key personnel on complex cases which require strategic intervention.

  • Independently and effectively resolves complex issues with creativity and innovation while maintaining compliance.

  • Refer patients to third-party or other foundation programs per program business rules.

  • Manage case triage to Specialty Pharmacy or Long Term Care Pharmacy, if applicable, and ensure proper information has been communicated to the Specialty Pharmacy Liaison.

  • Collaborate with SPs and field teams on case recovery efforts.

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