Virtual Case Manager

Virtual Case Manager

Inizio Engage has a long-standing partnership with a pharmaceutical company, across our Inizio Engage business to provide services to patients allowing access to care.  

The Virtual Case Manager provides services to patients allowing access to care for prescribed medications. You will talk with patients, physicians, and pharmacies related to providing access to care on behalf of our clients. You will be part of a patient access team to manage the patient experience from start to finish by providing services that may include benefits investigation, program information, eligibility, reimbursement support, and general resources. You will communicate with third parties to obtain benefits verification, enroll in copay support, and transfer patients to patient assistance programs. You are someone with extreme customer empathy, experience in patient care/healthcare case management and engagement, and someone with excellent software navigation skills.

This is your opportunity to join Inizio Engage and represent a top pharmaceutical company!

 What will you be doing?

• Serve as a patient advocate on behalf of the patient to coordinate access to medicines for timely treatment initiation, training, and ongoing shipments across HCP office, payer, and specialty pharmacy. 
• Understand a patient’s support needs and interaction preferences to deliver a seamless, tailored patient experience that helps each patient complete their treatment as prescribed by the HCP (Healthcare Professional). 
• Provide support to patients and HCPs (Health Care Professional) throughout the prior authorization and appeals processes.
• Educate providers and patients on relevant payer policies to help ensure patients can start and stay on therapy.
• Provide support to each assigned patient about their coverage status while maintaining accurate information in the designated computer system to support data integrity of information relayed to customers and clients. 
• Manage a regional caseload promptly as defined by Service Level Agreements.
• Triage accounts and patient cases to aligned Field Access Lead based on business rules established by client.
• Identify trends regarding reimbursement delays, patient concerns, and reports to leadership. 
• Communicate with assigned patients, e.g., patient insurance benefit information, available out-of-pocket support, etc.
• Communicate with Field Access Lead regarding patient updates, missing information, and delivery of benefits. 
• Collaborate with targeted providers and pharmacies by following up to ensure prescriptions are being processed.
• Help ensure patients have access to all information, by compliantly navigating payer reimbursement, and mitigating any patient out-of-pocket barriers, as applicable.
• Educate on and enroll patients in Patient Support Programs.
• Provide coverage by answering inbound calls from providers, clients, patients, care givers, and pharmacies when applicable.
• Follow all requirements associated with compliance with program regulations, including HIPAA (Health Insurance Portability and Accountability) and patient privacy.

What do you need for this position?

• Bachelor’s degree required. 
• Minimum 1-2 years of industry experience with pharmaceutical or healthcare case management and knowledge of medical or pharmaceutical terminology. 
• Experience with health insurance and Rx reimbursement. 
• Understand HIPAA and privacy laws and requirements and maintain patient confidentiality       
• Experience with Adverse Event and Product Quality Complaint reporting
• Maintain compliance with program business rules, standard operating procedures, and guidelines
• Outstanding case management is required
• Passionate about learning and able to share/communicate that passion to others
• Exhibit collaboration and follow up is necessary   
• You must demonstrate the ability to work in a dynamic and culturally diverse workplace.

Our Benefits:

• Great compensation package
• Excellent Benefits - accrued time off, medical, dental, vision, 401k, disability & life insurance, employee discounts/promotions 
• Generous performance-driven Incentive Compensation package
• Competitive environment with company wide recognition, contests, and coveted awards
• Exceptional company culture
• Recognized as a Top Workplace USA 2021 and Great Place to Work Certified 2022 and 2023