Case Manager - Rare Disease- TEPEZZA - West Coast Remote
Amgen
Full-time
Remote friendly (Los Angeles, CA)
United States
Operations
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Role Summary
Case Manager - Rare Disease- TEPEZZA - West Coast Remote
Responsibilities
- Daily interaction with Regional Business Managers (RBMs), Patient Access Liaison (PAL) and Medical Science Liaison’s (MSLs) to ensure current and accurate communication on the status of insurance approvals and reauthorizations
- Work closely with RBMs, PALs, the hub, pharmacy, and the patient/family to case manage all steps required to gain access to therapy
- Partner with Safety and Pharmacovigilance (PV). Report Adverse Event (AE)’s and product complaints through medical information
- Maintain case history for all U.S. patients, entering relevant notes from the hub, the pharmacy, calls to insurance, patient support programs, physicians and nurses, and the patients and families
- Maintain and update patient status to track reimbursement and shipping status of U.S. patients
- Triage, troubleshoot and resolve initial and ongoing reimbursement issues (PAs, denials, appeals, reauthorizations, overrides, billing problems)
- Liaise with medical offices as necessary to obtain insurance authorizations
- Counsel patients and family on insurance and reimbursement options
- Identify general and specific adherence trends and suggest appropriate action
- Report on weekly changes in patient status, current adjudication status of all patients, overall reimbursement trends, and any other trends, successes, or roadblocks
- Manage, track, and report on Open Enrollment efforts annually to ensure every patient has access to adequate insurance
- Advise patients and families on insurance, financial assistance and therapeutic access programs
- Attend patient meetings, industry conferences and sales meetings
Qualifications
- Master’s degree OR
- Bachelor’s degree and 2 years of Case Management experience Or
- Associate’s degree and 6 years of Case Management experience Or
- High school diploma / GED and 8 years of Case Management experience
Preferred Qualifications
- Bachelor’s Degree strongly preferred
- 5+ years of experience in the pharmaceutical industry
- 2+ years prior experience as a Case Manager
- Excellent communication skills and commitment to customer service
- Ability to effectively resolve hurdles across multiple cases at the same time
- Ability to learn product and disease information, familiarity with HIPAA and FDA
- Ability to manage communication with case managers and sales reps across multiple geographies and time zones
- Excel and PowerPoint skills required
- Up to 20% travel required