Case Manager, Reimbursement

Remote: 
Full Remote
Contract: 
Work from: 

Offer summary

Qualifications:

Bachelor’s degree or six years of relevant working experience, Two or more years of relevant experience in pharmacy benefit management preferred, Proficient in Microsoft Office applications, Excellent written and verbal communication skills..

Key responsibilities:

  • Serve as a patient advocate and single point of contact for patients, caregivers, and providers.
  • Coordinate patient access to therapies and follow up on cases to ensure timely processing.
  • Communicate patient benefits and responsibilities accurately and assess referrals for special programs.
  • Perform quality checks on cases and report trends to leadership while troubleshooting complex cases.

UBC logo
UBC Pharmaceuticals Large https://www.ubc.com/
1001 - 5000 Employees
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Job description

Exciting opportunities await as the Veloxis team continues to demonstrate its impact and success. We recognize the value of UBC’s internal talent and invite you to showcase your unique perspective and skills on a new team. This program will provide a platform for you to showcase your capabilities, take on new responsibilities, and develop professionally. If you are passionate, driven, and ready to take on new challenges, we encourage you to seize this incredible opportunity. Shape the future, apply today and let your talent shine within UBC! 

At UBC, the Reimbursement Case Manager serves as a patient advocate, removing barriers for patients accessing specialty pharmaceuticals. As the single point of contact you will provide inbound and outbound phone support to patients, caregivers, and providers to collaboratively determine patient eligibility. In addition to prioritizing and enhancing the patient experience, the reimbursement case manager will coordinate the patient's access to therapies, conduct the appropriate follow ups, and facilitate access to support services such as co-pay assistance programs and patient assistance programs (PAP). 

 Specific job duties:

  • Provide day-to-day oversight and coordination of caseload to ensure all case elements and tasks are completed timely and ensure cases move through the process as required.
  • Act as single point of contact responsible for prior authorization and appeal processing communications to patients, healthcare providers, field reimbursement representatives and other external stakeholders.
  • Communicate patient benefits and responsibility timely and accurately. 
  • Assess and refer patients appropriately for special programs/services when appropriate.
  • Performs quality checks on cases and report trends to leadership.
  • Responsible for good housekeeping techniques, adhering to quality and production standards while complying with all applicable company, state and federal safety and environmental programs and procedures. 
  • Troubleshoot complex cases, spanning multiple disease-states, while interfacing with key stakeholders (internal/external) to ensure optimal start to therapy
  • Report Adverse Drug Events that have been experienced by the patient in accordance pharmaceutical requirements.
  • Recognize a product quality complaint and forward caller/written information to a manufacturer.
  • Other duties, as assigned.

 

Desired Skills and Qualifications:

  • Bachelor’s degree or six years of relevant working experience
  • Two (2) or more years of relevant experience in pharmacy benefit management preferred
  • Medical Assistant, Social Worker or Senior Reimbursement Specialist experience preferred
  • Proficient in Microsoft Office applications
  • Knowledge of medical and claims processing terminology 
  • Excellent written/verbal communication to include providing clear instructions


Benefits:

At UBC, employee growth and well-being are always at the forefront. We offer an extensive range of benefits to ensure that you have everything you need to thrive personally and professionally. 

Here are some of the exciting perks UBC offers:

  • Remote opportunities
  • Competitive salaries
  • Growth opportunities for promotion
  • 401k with company match*
  • Tuition reimbursement
  • Flexible work environment
  • 20 Days PTO Annually (accrued)
  • Paid Holidays
  • Employee assistance programs 
  • Medical, Dental, and vision coverage
  • HSA/FSA
  • Telemedicine (Virtual doctor appointments)
  • Wellness program
  • Adoption assistance
  • Short term disability
  • Long term disability
  • Life insurance
  • Discount programs


UBC is proud to be an equal opportunity employer and does not discriminate because of race, color, sex, age, national origin, religion, sexual orientation, gender identity and/or expression, status as a veteran, and basis of disability or any other federal, state, or local protected class. We are committed to a diverse, equitable and inclusive culture that fosters respect for each other, our clients, and our patients.

#LI-remote  #LI-MR1



Required profile

Experience

Industry :
Pharmaceuticals
Spoken language(s):
English
Check out the description to know which languages are mandatory.

Other Skills

  • Microsoft Office
  • Communication
  • Detail Oriented
  • Problem Solving

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