Randstad Case Manager in Rockland, Massachusetts
salary:$20 - $26.93 per hour
date posted:Monday, January 4, 2021
industry:Professional, Scientific, and Technical Services
As the world's largest staffing and recruitment agency in the world, we can commit to find you the perfect role that gives you the opportunity to learn and grow in the life sciences arena. Utilizing a recruiter for your job search gives you access to a large network of top employers as well as detailed information about hundreds of positions. We supply prestigious life sciences and biopharma companies with job seekers like you to achieve their business goals. If you're looking for a position where you can serve as an asset to your company while making a difference in others' lives, we have the ideal position for you!
location: Rockland, Massachusetts
job type: Contract
salary: $20.00 - 26.93 per hour
work hours: 11 to 7
Consistently provide a high level of customer service to both internal (sales force, field patient support, nurses) and external customers (patients, physicians, pharmacies, insurers).
Maintain accountability for day-to-day patient case management activities, workload and overall workflow.
Manage tasks and activities in a timely manner within assigned geographic area to ensure a high level of patient and physician satisfaction
Provide feedback to patient or provider on services offered and share unique situations/issues to ensure common response from patient support services.
Provide feedback to patients or provider relative to insurance coverage with certain carriers and/or plans.
Work on patient's behalf to identify and assess reimbursement coverage options for those with insurance and to coordinate and/or investigate financial options for those without insurance.
Work with third party vendors responsible for benefits verification and coverage requests to ensure information obtained is accurate and timely.
Work with physician offices and/or pharmacies to facilitate the process of obtaining prior authorization from third party payers in order to maximize patients' access to treatment.
Help support the appeal process, with consent from the patient, caregiver and/or the provider
Manage and maintain productive relationships with patients and their HCPs to ensure maximum process efficiency.
Deliver presentations regarding patient support options to provider's offices where appropriate and consistent with compliance guidelines.
Align with managed care account managers and market access colleagues at the regional level to maintain a knowledge regarding Payors, Pharmacies and maintain a working knowledge regarding formulary opportunities or challenges.
Maintain database for recording, managing, and monitoring patient activities for those requiring access support.
Upon request, provide feedback and data on territory performance, payers, and HCP relationships to departmental manager
Maintain a collaborative approach with members of call center team in order to offer the best possible outcome for all customers.
Demonstrate the utmost sensitivity and confidentiality to information while maintaining a high level of professionalism.
Assume additional projects on an as needed basis.
Continued education and training is required in order to maintain technical expertise in the assigned therapeutic area and to keep current on approved product information and promotional items.
Capability to monitor drug coverage policies for multiple payers. Review case outcomes to analyze and identify payment and denial trends as well as key findings for client reporting.
Ability to effectively respond to escalated issues and complex cases referred from other Reimbursement employees or internal/external stakeholders
A minimum of two years reimbursement and customer care experience in a medical field and/or pharmacy technician experience is favorable.?Preferably with patient interaction or educational support
College Degree required (Associates/ Bachelors) or equivalent.?Pharmacy Technician is a plus
Bilingual capability is a plus.
skills: MS-WORD, MS-EXCEL
Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.
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