Case Manager, Reimbursement

United Biosource New York, New York, US

About the Role

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 UBCwe 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! This opportunity requires the successful individual to work a shift pattern of 11:00am to 08:00pm EST Brief Description

: The primary purpose of this position is to provide day-to-day case management oversight and coordination of assigned caseload to ensure parties responsible for tasks are completing them timely, as well as act as a primary resource for patients, healthcare providers and field reimbursement. The Case Manager is responsible for ensuring prior authorizations, reauthorizations and appeals are obtained in a timely manner, as well as ensuring accurate documentation of payer information and patient status. In addition, the Case Manager is responsible for completing a pre-screen to determine eligibility for additional services such as injection services, co-pay mitigation, and patient assistance programs (PAP), if applicable. 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. Communicate patient benefits and responsibility timely and accurately. Assess and refer patients appropriately for special programs/services when appropriate. 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. Other duties, as assigned. Supervisory Responsibility: N/A Desired Skills and Qualifications: Bachelor’s degree or six years of relevant working experience Two (2) or more years of relevant experience in pharmacy benefit management preferred Medical Assistant, Social Worker or Senior Reimbursement Specialist experience preferred Certification preferred but not required 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 Benefits

: 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 Discretionary PTO (Paid Time Off) 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-HB1 #LI-REMOTE

Responsibilities

  • Oversee and coordinate caseload to ensure tasks completed timely
  • Obtain prior authorizations, reauthorizations and appeals
  • Document payer information and patient status

Qualifications

  • Bachelor's degree or six years of relevant experience
  • Two+ years experience in pharmacy benefit management preferred
  • Experience in medical assisting, social work or senior reimbursement specialist preferred

Benefits

Remote work option
Employee benefits

Required Skills

case management pharmacy benefit management documentation communication critical thinking

Keywords

case management reimbursement pharmacy payer patients

Interested in this role?

Apply now and take the next step in your career.

Apply Now

Job Overview

Date Posted 2 days ago
Location New York, New York, US
Job Type Full-time
Work Mode Onsite
Experience 6+ years
Category Healthcare allied health

About the Company

United Biosource