Case Manager, Metabolics (PST)

Remote position supporting Pacific Standard Time Zone (11:30am EST – 8pm EST) with occasional patient meeting and HCP office support, up to 6x/year, outside those hours of operation. Up to 10% potential travel to existing Alexion sites, patient meetings by request and HCP offices as requested and when appropriate.

This is what you will do:

This position is a high-touch Patient Services role centered on delivering personalized support to patients within the Alexion Rare Disease patient journey.  

The Case Manager (CM) serves as the primary point of contact to patients and caregivers throughout their treatment journey from onboarding, interim treatment coordination, and long-term customized treatment adherence support.  CMs provide disease state education, treatment support, and access for patients with rare and ultra-rare diseases.  CMs ensure patient treatment compliance and provide resolutions to treatment issues for patients through communication and collaboration with both internal and external stakeholder partners.

You will be responsible for:

Patient Support & Navigation (70%)

• Patient’s Initial and Long-term Support: Provide initial and ongoing patient interactions to address questions and integrate therapy into their daily lives

• Act as the primary point of contact for case management and onboarding activities specific to the patient

• Place Welcome Calls: After case creation in the CRM, place the required welcome calls to patient (and HCP in coordination with SP vendor) and introduce the program or confirm required support respectively

• Share Disease, Product & Program Education Materials: Share materials on disease, diagnosis, and treatment support with patients

• Introduce Patient Community: During the first touchpoint, Connect the patient to the ALXN patient community and inform them about available advocacy groups for the indication

• Communicate Benefits Investigation Results: On receiving the BI results from the SP vendor, contact the patient and share results

• Coordinate Injection Training Support: Assist patients in receiving In-home or virtual injection training assistance during first injection and coordinate follow up service as needed for second round of injection training (also offer infusion support)

• Conduct Adherence Program Touchpoints: Trigger initiation of adherence program on conclusion of onboarding and connect with patients through defined channels for the determined touchpoints based on product specific programs

• Execute Mentorship Program: Engage appropriate patients to become mentors if desired to new patients starting therapy and enable them to connect

• Support Patients who Restart on Treatment: Reconnect with patients who have lapsed and decided to restart on treatment, offer support services

• Conduct Annual BI Communications with patients

• Practice vigilant documentation and record keeping during all patient interactions as to maintain high visibility into patient case status and ease resolution processes, when needed

• Properly and immediately report Adverse Events during any customer interactions in the PV Event Reporting Tool

Internal Cross-Functional Collaboration (15%)

• Develop compliant and collaborative professional relationships with all relevant internal and external customers including but not limited to Field Reimbursement Managers, Regional Account Managers, Customer Operations Representatives, medical accounts, Funding Specialists, Access Specialists, Specialty Pharmacies, site of care staff, and office coordinators.

• Effectively escalate access issues by informing the right stakeholders of actions to be taken to resolve any pending items in a timely manner

• Collaboratively work with and share responsibilities with other Alexion members and external partners members for pull through of the target patient and HCP experience

External Vendor Engagement and Collaboration (15%)

• Develop compliant and collaborative professional relationships will all relevant external vendor partners including but not limited to PantheRx SP Enhanced Services partners, Ashfield In-Home Injection Trainers, Product Storage Service vendors, Sharps Disposal service vendors, and Copay and BI support vendors

• Effectively escalate vendor service provider issues which may impact patients by informing appropriate internal stakeholders and taking needed actions to resolve issues in a timely manner

• Collaboratively work with and share responsibilities with external vendor partners to optimize and create a delightful patient and HCP experience

You will need to have:

• BA/BS Degree is required; a counseling, social work, nursing, advocacy, or science background and/or advanced degree is a plus

• Minimum of 3 to 5 years Case Management OR recognized equivalent of education and experience (e.g. case management, nursing, social service support, insurance reimbursement, patient advocacy, etc.)

• Working knowledge of insurance coverage and reimbursement processes

• Familiarity with the relevant legal and regulatory components of the pharmaceutical and biotech industry

• Well-developed, effective communication and problem-solving skills, as well as data entry/computer literacy skills

• The duties of this role are generally conducted in a home office environment.  As is typical of an office-based role, employees must be able, with or without an accommodation to: use a computer; engage in communications via phone, video, and electronic messaging; engage in problem solving and non-linear thought, analysis, and dialogue; collaborate with others; maintain general availability during standard business hours.

We would prefer for you to have:

• Rare disease experience a plus

• Deep understanding of insurance coverage and reimbursement processes

• Familiarity with managed care and particularly “buy and bill” and pharmacy benefit therapies as well as with reimbursement for infused and injectable therapies

• Ability to coordinate with cross-functional teams for pull-through of patient care

• Experience dedicated to assisting patients/caregivers

• Demonstrated success working within cross-functional teams

• Strong empathetic, communication and listening skills

• Ability to act with urgency, flexibility, and creativity to quickly get patients on therapy

• Strong organizational skills and ability to adapt to change and react constructively in a high-energy and fast paced environment

• Demonstrates initiative, teamwork, and accountability

Date Posted

Closing Date