Senior Case Manager
Current-Responsible for training other case management staff. Upholding standards set in place by management. Coordinates, oversees and evaluates program operations. Make and implement process improvement actions to help make the process more efficient. - Responsible for communications and management of concerns regarding treatment. Including striving for one call resolutions. - Point of contact for patient, Access Reimbursement Manager (ARM), the Health Care Provider (HCP), Site of Care (SOC) representative, including concierge “white glove” clinics.- Primarily responsible for supporting the needs of the client representatives within a geographic territory.- Provide (enrollment, claims) support for Copay Assistance Program.- Verify eligibility and enroll patients in Free Goods (Patient Assistance Program, Quick Start, Interim doses etc.) Triage (Patient Assistance Program) PAP / (Quick Start) QS etc. to pharmacies. Work with HCP / SOC for acceptance of Free Goods and coordinate and verify delivery of Free Goods.- Review cases for pharmacovigilance: detecting and reporting adverse reactions to drugs.- Specialty Pharmacy Liaison – Triaging prescriptions to Specialty Pharmacy, following up on status, coordinating delivery with HCP / SOC. - Prior Authorization follow up - Calling payer / insurance companies and coordinating with HCP and SOCs to obtain prior authorizations.- Benefits Investigation – Calling payer to obtain, confirm and verify patients benefits and eligibility. - QA Contractor - Quality assurance audits of VOBs for re-verifications and annual review.
