Case Manager, Patient Services -Rare Disease (West Coast Candidates)

Role Summary

The Case Manager will provide personalized assistance to patients/caregivers with complex and rare medical conditions. Reporting to the Team Lead, Patient Services, the Case Manager will navigate patient’s healthcare insurance, perform administrative functions and interact with Patients, Caregivers, HCPs, Field Sales, Payers, Specialty Pharmacies and Patient Engagement. The Case Manager will be the face of PTC to patients and internal/external customers. The Case Manager will serve as a resource to their teammates and Team Lead.

Responsibilities

• Work directly with patients/caregivers to help them obtain access to PTC products.
• Quickly build positive working relationships with patients, caregivers, HCPs, patient engagement, and the sales team to collect/share appropriate information and coordinate patient care.
• Solve problems with urgency to help patients/caregivers gain access to therapy and maintain adherence.
• Communicate with internal and external stakeholders while maintaining the confidentiality of patient health information and acting in compliance with all laws and regulations and facilitating coordination of information/resources.
• Navigate the CRM system with ease and rapidly learn internal business rules and processes.
• Report Adverse Events and Product Quality Complaints.
• Adheres to PTC’s Standard Operating Procedures and Business Rules.
• Accurately interprets patient insurance, prescription, and other health-related documentation as needed.
• Responsible/Accountable for handling all aspects of patient cases and must be able to complete follow-up promptly and professionally.
• Performs clerical and administrative functions such as mailing and faxing.
• Acquire/Exhibit/Maintain subject matter expertise in the area of orphan/rare disease, including but not limited to the condition, treatment, community of patients and caregivers, activities and events offered throughout the country, etc., to ensure staff is providing the appropriate support/service(s).
• Applies subject matter expertise to drive positive patient outcomes.

Qualifications

• Required: Bachelor’s degree with 3 to 5 years of Case Management or recognized equivalent of education and experience with orphan/rare disease biotech environment experience. Rare disease experience required.
• Case Management (or related) experience demonstrating strong problem-solving and solution skills.
• Ability to anticipate patients' needs and respond quickly, flexibly and creatively to solve problems.
• Ability to work independently and collaboratively in a team environment consisting of internal and external team members.
• Proficiency with Microsoft Office.
• Excellent verbal and written communication skills.
• Excellent organization and time management skills including the ability to support and prioritize multiple tasks.
• Ability to enter data quickly and accurately into CRM.
• Speak clearly and pleasantly.
• Active listening skills.
• Adapt to a quickly changing environment.
• Working knowledge in pharmacy billing, prior Authorization, appeals, and peer-to-peer review.

Special Knowledge Or Skills And/or Licenses Or Certificates Preferred

• Bilingual/Spanish Speaking is a plus.
• Pharmacy Technician.
• HCP Office Management.
• Experience working with Sales Reps.
• Case Management experience in a rare disease environment.
• Registered Dietitian License preferred but not required.

Travel Requirements

• Domestic: Up to 10%

Education