As a pharmaceutical support industry leader, UBC is devoted to empowering health solutions for a better tomorrow. We take pride in improving patient outcomes and advancing healthcare. At UBC we provide services to enhance the entire drug development process and commercialization lifecycle - From clinical trial support to real-world evidence generation.
Embark on a rewarding career journey with UBC! Grow your career while making a meaningful impact on the world around you. UBC fosters a culture built on our Core Values being Collaborative, Conscientious, Curious, Consultative, and Compassionate. We believe in an inclusive workplace that fosters creativity.
If you are seeking a career that will challenge, inspire, and reward you, join us at UBC!
Job Title:
CEG05F- Sr. Case Manager
Brief Description:
At UBC, the Reimbursement Case Manager serves as a
patient advocate, removing barriers for patients accessing specialty
pharmaceuticals. As the single point of contact you will provide inbound and
outbound phone support to patients, caregivers, and providers to
collaboratively determine patient eligibility. In addition to prioritizing and
enhancing the patient experience, the reimbursement case manager will
coordinate the patient's access to therapies, conduct the appropriate follow
ups, and facilitate access to support services such as co-pay assistance
programs and patient assistance programs (PAP).
Specific job duties:
- Provide day-to-day oversight and coordination of caseload to ensure all case elements and tasks are completed timely and ensure cases move through the process as required.
- Act as single point of contact responsible for prior authorization and appeal processing communications to patients, healthcare providers, field reimbursement representatives and other external stakeholders.
- Serve as a patient advocate and resource for patients as they navigate through the reimbursement process while coordinating any additional patient access services within program guidelines.
- Performs quality checks on cases and report trends to leadership.
- Responsible for good housekeeping techniques, adhering to quality and production standards while complying with all applicable company, state and federal safety and environmental programs and procedures.
- Troubleshoot complex cases, spanning multiple disease-states, while interfacing with key stakeholders (internal/external) to ensure optimal start to therapy
- Report Adverse Drug Events that have been experienced by the patient in accordance pharmaceutical requirements.
- Recognize a product quality complaint and forward caller/written information to a manufacturer.
- Act as point of contact for case managers to assist with prior authorization and appeal requirements, provide guidance, answer process questions and address escalated issued when appropriate. Provides support for at-risk patients and prescribers to help mitigate any lapse in the start or continuation of therapy.
- Collaborates with other senior case managers, managers and quality team on a monthly basis to review quality trends, creating process improvement initiatives for the next month.
- Prepares and presents team huddles, and client presentations as deemed appropriate (minimum one presentation per month)
- Other duties, as assigned.
Supervisory Responsibility:
N/A
Desired Skills and Qualifications:
- Bachelor’s degree or six years of relevant working experience
- Five (5) or more years of relevant experience in pharmacy benefit management, specialty pharmacy or patient support/access (HUB) services preferred
- Three (3) or more years of relevant experience in pharmacy and/or medical benefit verifications, prior authorization and/or appeals required.
- Medical Assistant, Social Worker or Senior Reimbursement Specialist experience preferred
- Bilingual (Spanish/English) a plus
- Comply with occasional company sponsored travel requirements
- Proficient in Microsoft Office applications
- Knowledge of medical and claims processing terminology
- Excellent written/verbal communication to include providing clear instructions
- Must possess a strong critical thinking skillset along with the ability to multi-task
At UBC, employee growth and well-being are always at the forefront. We offer an extensive range of benefits to ensure that you have everything you need to thrive personally and professionally.
Here are some of the exciting perks UBC offers:
- Remote opportunities
- Competitive salaries
- Growth opportunities for promotion
- 401K with company match*
- Tuition reimbursement
- Flexible work environment
- 20 days of PTO, accrued
- Paid Holidays
- Employee assistance programs
- Medical, Dental, and vision coverage
- HSA/FSA
- Telemedicine (Virtual doctor appointments)
- Wellness program
- Adoption assistance
- Short term disability
- Long term disability
- Life insurance
- Discount programs
UBC is proud to be an equal opportunity employer and does not discriminate because of race, color, sex, age, national origin, religion, sexual orientation, gender identity and/or expression, status as a veteran, and basis of disability or any other federal, state, or local protected class. We are committed to a diverse, equitable and inclusive culture that fosters respect for each other, our clients, and our patients.
#LI-Remote
#LI-AE1
