Lead, Case Management, Rare Diseases

Purpose

The Lead, Case Management is responsible for ensuring consistent, efficient, and quality Patient Services Operations in collaboration with the boarder Patient Services Team. Overseeing the internal Patient Services team, this contributor will ensure a compliant patient and customer experience. This person will provide leadership to a highly visible team of customer service team leaders and case management professionals. Ensure that clear goals and objectives are set for the group and that they are being executed against on a daily basis. Responsible for providing strategic direction and identifying opportunities to improve team skill sets and overall service offerings.

Main Responsibilities

• Providing leadership and management to customer service team leaders and customer service case management professionals.
• Support Patients and family throughout all steps required to gain access to therapy
• Manage day-to-day patient access and support services focused on internal team members and case management
• Accountable for internal team performance to key metrics and quality standards
• Regularly coaches and provides feedback to team based on regular case reviews and quality monitoring
• Executes business objectives related to Patient Services Operational excellence
• Develops necessary Patient Services Trainings for internal and external teams
• Identify, develop and implement key service model improvements through collaboration with the Field Reimbursement Directors, National Account, Sales and Marketing teams based on the needs of internal and external key stakeholders.
• Planning, assigning, and directing workloads and performance management for respective teams.
• Interaction with field sales team to ensure customer problem resolution 
• Trouble shooting and providing advice to case managers on difficult cases
• Coordinate process changes and CRM improvements with managed services
• Ensures individual and program compliance with all laws, regulations, and policies that govern the conduct of patient support programs or activities and patient privacy. 
• Team will be responsible for: 
  • Working closely with patients and caregivers to gain access to therapy including entry of patient intake information 
  • Working with Payers, Specialty Pharmacy and other partners to obtain reimbursement information 
  • Counseling patient/family on reimbursement options 
  • Partnering with Field Reimbursement Directors to ensure patient and medical office problem resolution 
  • Acting as the liaison with medical offices and hospitals 
  • Professionally field incoming telephone calls while making a positive impression 
  • Answering client inquiries and resolving client problems 
  • Providing ongoing persistency and compliance support
     

Experience Required

• 5+ years of direct management experience required in a patient support or healthcare management role (biopharmaceutical industry/ rare disease preferred) 
• Experience with Microsoft Office programs required (Word, Excel, Power Point, Outlook, Teams) 
• Expertise in Patient Services and Call center operations
• Expertise in patient focused programs with HIPAA regulations and patient privacy policies
• Expertise in Reimbursement/policy landscape critical
• Reimbursement experience with the ability to communicate complex reimbursement scenarios to patients and medical professionals 
• High aptitude for learning complex processes and adaptability to change 
• Patient-focused

Education

Minimum bachelor’s degree or higher degree in a Healthcare related field preferred