Case Manager

Overview

We are continuing to build out our US Patient Services team to provide exceptional customer service on all levels. Reporting to a Regional Manager, the Case Manager (CM) is a non-sales regional field-based position that will be responsible for providing a smooth customer interaction from intake through supporting continued patient access to therapy by educating physicians, genetic counselors, nurses, pharmacists and ancillary staff, as well as patients, caregivers, and families to address and prevent barriers to patient access. Allocation of time will be adjusted as needed to meet the needs and objectives of patient access and site support for the TTR Business.

The CM’s focus will be to optimize access to Alnylam products in his/her region by understanding and addressing patient access challenges. This position requires a professional who can leverage their expertise and experience to manage access issues as patient-specific therapy is initiated and leading action plans to resolve access issues as they arise post-therapy initiation.

A key component of this role is the ability to establish and deepen customer relationships through quality interactions. The CM will also utilize a regional team approach while working with numerous internal cross-functional partners such as; Patient Services team members, Market Access, Field Sales, Strategic Accounts, Patient Advocacy and Marketing to facilitate and optimize patient carewhile supporting Alnylam’s patient-focused vision of harnessing a revolution in biology for human health®.

The successful candidate must exhibit technical knowledge of health care reimbursement from a patient/provider perspective as well as the ability to interact with physicians, staff, and sites of care.They must also possess a positive attitude, be passionate about science and deeply motivated by the quest of delivering value to patients and their families with the long-term success of the company in mind.

The CM will manage the logistical issues impacting treatment initiation and ongoing therapy while demonstrating an understanding of the company’s business objectives and measures and working independently as well as collaboratively within a highly matrixed environment.

Summary Of Key Responsibilities

• Assess patients’ needs and develop individual action plans that provide for the initiation and continuation of treatment with Alnylam products while coordinating the exchange of all applicable patient-related information with appropriate internal and external stakeholders
• Minimize access barriers for patients by establishing relationships and serving as a resource for patient access and product procurement
• Communicate with patients and caregivers to facilitate personalized coordination of patient care
• Leverage cross functional partners on overall accounts and territory strategy to increase internal/external customer knowledge on payor policy and processes
• Proactively communicate Alnylam specific patient services programs, policies, and procedures so that the office staff is fluent in how to use access programs and systems
• Provide case-specific guidance in response to PA and policy requirements, denials, patient assistance programs, and related resources , and post service reimbursement issues as it relates to copay claims issues
• Be knowledgeable of changes in payer landscape and access environment; identify areas that may impact access and communicate information to appropriate channels
• Collaborate cross functionally while abiding by all corporate and industry policy guidelines and procedures
• Maintain accurate documentation on each patient, their insurance, coverage approvals, on-going coverage requirements, and all patient and provider interactions
  
  

Qualifications

• BS/BA or relevant four-year degree
• PACs certification preferred, but not required
• Rare Disease Patient/ Caregiver Case Management with experience working through complex reimbursement issues
• 3+ years recent case management experience in the healthcare or pharmaceutical/biotech industry. Rare disease experience a plus.
• Comprehensive understanding of all aspects of reimbursement models, including a complete understanding of Medicare A, B, C and D
• Ability to communicate effectively around Key Strategic Initiatives to Peer Groups
• Skilled professional with a comprehensive understanding of field/patient reimbursement
• Work strategically in a cross functional team environment and influencing without authority
• Desire to innovate and work in a fast-paced, energetic environment
• Competencies Include: Strong Written and Verbal Communications, Ability to Problem Solve, Active Listener, Presentation Skills, Teamwork & Collaboration, Customer Service Focus, and Adaptability
• Self-starter who is highly passionate about rare disease and Alnylam’s core values:
• Commitment to People, Innovation, Discovery, Purposeful Urgency, Open Culture, and Passion for Excellence.
• Travel up to 5% , as needed.