Case Management Specialist

Role Summary

Case Management Specialist - Remote. Responsible for coordinating care for patients receiving Tzield, Sanofi's disease-modifying therapy for type 1 diabetes (T1D), including engaging with patients and families, facilitating insurance approvals, and developing personalized care plans to address barriers to treatment.

Responsibilities

• Act with urgency and purpose, leading the case management process for Tzield patients while balancing patient needs with business objectives
• Serve as the primary point of contact and champion for patients from enrollment through treatment completion
• Engage patients and families to uncover needs, understand challenges, and provide education and support to start Tzield therapy
• Assess insurance coverage options, limitations, and requirements; advocate to ensure successful initiation of Tzield treatment
• Educate patients, caregivers, and healthcare providers on Tzield coverage and steps to obtain product and administration approval
• Maintain understanding of the reimbursement process, healthcare systems navigation, billing/coding guidelines, and payer trends
• Enroll eligible patients into appropriate financial assistance programs as needed
• Maintain knowledge of regional resources and market landscape to support patient access to therapy
• Coordinate the exchange of patient information with internal and external stakeholders
• Demonstrate initiative within the cross-functional regional team, identifying complex issues and developing action plans
• Document all interactions with attention to data integrity
• Provide caseload coverage outside assigned territory as needed
• Ensure compliance with all Sanofi policies

Qualifications

About You

• Bachelor's degree preferred
• 3-5 years of patient-facing or high-touch customer interaction experience preferred
• In-depth understanding of health insurance benefits
• Excellent written and oral communication and problem-solving skills
• Experience in a complex matrix environment to accomplish goals
• Strong interpersonal skills: flexibility, persistence, creativity, empathy, and trust
• Ability to handle sensitive issues, work independently and collaboratively
• Ability to travel within the US, up to 10%

Preferred Qualifications

• Salesforce CRM experience
• Direct experience in case management, reimbursement, insurance, or healthcare systems
• Pharma/biotech patient services and specialty product experience
• Experience with payer policy requirements and multiple prior authorizations
• Experience with T1D patients or autoimmune conditions
• Home care coordination experience
• Buy & Bag and white bag experience