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Medical Case Manager

2 months ago

tempe, United States Randstad Full time

Contract: 6 Months

Pay Rate: $29 to $31/hr

Location: Tempe, AZ (Hybrid)


Schedule: 8:00 am EST – 5:00 pm EST/9:00 am – 6:00 pm EST or 11:00 am EST – 8:00 PM EST


Overview:


The Patient Support Center (PSC) plays a crucial role in helping eligible patients access and continue their prescribed medications. We work directly with patients, caregivers, and prescribing customers to provide education and support on access, affordability, acquisition, and adherence programs.

Our team has supported millions of patients in the US, assisting over 500,000 patients annually. The Patient Support Center (PSC) is the central operational function within our organization. We handle all patient, caregiver, and customer transactions related to supporting patient access, including intake, case management, benefits verification, prior authorization and appeals support, specialty pharmacy triage, and adherence support. We are committed to delivering exceptional customer service, which is measured through service level agreements (SLAs), key performance

indicators (KPIs), and net promoter scores.

Overview of job:


The Case Manager serves as the dedicated point of contact to patients and healthcare professionals when initiating treatment of a Company therapy.

Responsibilities include:

Navigating through onboarding, insurance verification, financial assistance, and ongoing support as requested by the patient and their healthcare professional.

Case Managers will also be working with cross-functional team members within Patient Support, where appropriate, to ensure continuity of information being shared

with the healthcare professional and patients.


As a Case Manager, you will be assigned a specific territory to work within and become an expert in that regional area to best assist the individuals who call in, submit service request forms (SRFs) or required financial assistance.

Case Managers will possess critical thinking and communication skills, an aptitude

for learning and strive for continual development.


The Case Manager must have strong communication skills to converse with customers about the patient’s journey and be able to offer next steps in accordance with approved procedures.

The Case Manager will possess an aptitude for learning, the ability to accept and implement constructive feedback, and a continual development mindset.

In addition, the Case Manager will reflect a calm and reassuring tone and attitude for our patients, their families, and their caregivers, specifically during difficult or stressful interactions.


Your responsibilities will include, but are not limited to:

  • Develop and maintain Subject Matter Expert (SME) level knowledge of the relevant brand and customer workstreams for the specific assigned program
  • Learn and utilize protocols to respond to customer phone, chat, fax, SMS / text, mail, and e-mail inquiries as well as other communication channels in a prompt and courteous manner
  • Professionally and compliantly interact with customers, relevant associates, and other external contacts during inbound and outbound phone calls
  • Manage assigned cases throughout the patient journey; perform proper and timely escalation, tracking, triage and follow-up where required
  • Handle complex interactions and/or cases as it pertains to navigating insurances and financial assistance
  • Adhere to call guides, job aides and work instructions for case processing and case cadence
  • Adhere to Service Level Agreements (SLAs), Key Performance Indicators (KPIs), productivity, and quality metrics
  • Leverage dual monitors and technological solutions to support Case Management activities
  • Accurately and concisely document all interactions to inform cross-functional partners on the relevant status details
  • Promptly and courteously respond to tasks and notifications from PSC counterparts
  • As applicable, raise innovative ideas which will drive improved efficiency and effectiveness of customer service to Supervisors
  • Responsible for identifying and reporting adverse events via the established systems as per applicable processes

What you’ll bring to the role:


Education:

  • o High School Diploma required, associate or BS/BA degree preferred

Travel requirements:

  • This job requires you live within 90 miles of the East Hanover, NJ or Tempe, AZ site
  • Proximity and ability to commute to work onsite in East Hanover, NJ or Tempe, AZ as required by our hybrid model and for occasional meetings or events. To be scheduled at the discretion of the business. Onsite expectations one week per month and occasional meetings or training as needed.

Other Work Requirements:

  • When working from home, a quiet dedicated space with internet/WiFi service or the ability to obtain such service where the employee can work without interruption
  • Ability to work the scheduled work hours, which generally will be a 9-hour shift with two paid rest breaks and an unpaid lunch break; Working schedule is either 8:00 am EST – 5:00 pm EST/9:00 am – 6:00 pm EST or 11:00 am EST – 8:00 PM EST
  • Ability to complete all calls once they have begun to ensure no interruption of service
  • For Patient Support Center (PSC) Roles with a Dedicated Training Period: The individual hired for this role will be required to successfully complete initial training, including passing simulations and become certified to do the role

Required Experience:

  • Minimum 3 years of relevant patient service support experience (such as Healthcare, Pharmaceuticals, Patient Services or Contact Center Experience
  • Strong interpersonal, telephone and verbal communication skills, including the ability to project warmth and compassion while effectively and efficiently conveying information
  • Excellent written communication skills including the ability to interpret, capture and document the essence of and next steps for customer conversations in a clear and cogent way
  • Must follow oral and written directions
  • Ability to multitask and balance multiple priorities at once
  • Computer literacy in with email, video conferencing systems, and data entry/case management systems

Preferred Experience:

  • Experience working with Salesforce or other CRM platforms
  • Strong business acumen
  • Bi-lingual, Spanish speaking preferred

Therapeutic area experience

  • No therapeutic area experience required.