Associate Case Manager (Virtual, West Coast)

Associate Case Manager (Virtual, West Coast)

Overview

Our Patient Services team provides exceptional customer service on all levels. The Associate Case Manager role is a integral component of the commercial strategy and responsible for working collaboratively with Case Managers to complete tasks that will provide access and therapy management services for Alnylam’s portfolio of products. Reporting to Regional Manager, US Patient Services, the Associate Case Manager will be responsible for a variety of day-to-day operations. The description below is not intended to provide an all-inclusive listing of duties and responsibilities. Duties may change at the discretion of management, and/or management may request duties be performed that are not listed.

Key Responsibilities

• Verify and re-verify insurance coverage policies and benefit details through direct contact with payers
• Receive incoming referrals from providers, via fax queue (or other means)
• Maintain workflow of clearing, sorting, and distribution of incoming faxes
• Ability to prioritize work duties to maintain customer satisfaction through prompt and efficient service
• Accurately interprets patient insurance, prescription, and other health related documentation
• Enter and maintain accurate data on individuals, their insurance, and all payer interactions
• Send Summary of Benefits to Providers and Field Reimbursement Directors
• Research and identify payer Prior Authorization Processes and obtain necessary documents and requirements to disseminate to Case Management Team
• Submit and Track referrals to Specialty Pharmacies, as needed
• Maintain up-to-date knowledge of the reimbursement process, billing/coding guidelines, healthcare policy, payer trends
• Participate in projects and/or assignments including, but not limited to, QC initiatives, interdepartmental projects, etc.
• Demonstrate adaptability and flexibility; seek out opportunities to support your teammates
• Navigate customer-relationship management (CRM) platform in daily interactions and learn internal team processes for full understanding of Alnylam’s Patient Services
• Maintain confidentiality of patient health information and act in compliance with all laws, regulations, and Alnylam Company policies
• Outreach to Sites of Care related to initial and ongoing treatment

Qualifications

• Bachelor’s Degree required
• 1-2 years of experience with customer service, account management, case management, or healthcare field experience
• Rare disease experience preferred
• Knowledge of private payer, Medicare, and Medicaid structure, systems, reimbursement process and medical terminology
• Experience working in a high-volume patient services program preferred
• Effective communication, ability to think critically and problem solve
• Willingness to learn and adapt quickly in a fast-paced environment
• Ability to work cooperatively as a team member and have well-developed interpersonal skills
• Must reside in western region
• Self-starter who is highly passionate about rare disease and Alnylam’s core values:
• Commitment to People, Innovation, Discovery, Sense of Urgency, Open Culture, and Passion for Excellence

About Alnylam

We are the leader in RNAi therapeutics – a revolutionary approach with the potential to transform the lives of people with rare and common diseases. Built on Nobel Prize-winning science, Alnylam has delivered the breakthroughs that made RNAi therapeutics possible and are just at the beginning of what’s possible. Our deep pipeline, late-stage programs, and bold vision reflect our core values: fierce innovation, passion for excellence, purposeful urgency, open culture and commitment to people. We're proud to be a globally recognized top employer, where an authentic, inclusive culture and breakthrough thinking fuel one another.

At Alnylam, we commit to an inclusive recruitment process and equal employment opportunity. Qualified applicants will receive consideration for employment without regard to their sex, gender or gender identity, sexual orientation, race, color, ethnicity, national origin, ancestry, citizenship, religion, creed, physical or mental disability, pregnancy status or related conditions, genetic information, veteran or military status, marital or familial status, political affiliation, age, or any other factor protected by federal, state, or local law. Alnylam is an E-Verify Employer.