Case Manager

Horizon Pharma   •  

IL

Industry: Pharmaceuticals & Biotech

  •  

5 - 7 years

Posted 120 days ago

This job is no longer available.

Working at Horizon Pharma is more than a job – it’s personal. We define success by a different set of numbers: the number of lives touched, the number of lives changed, the number of lives saved. We’re a team of agile, out-of-the-box thinkers who are inspired to do more because we know we’re a part of something bigger. We strive to build meaningful careers at a company whose values we share because when we live up to our potential, we help patients live up to theirs.

Responsibilities

  • Day to day oversight and awareness of patient customer service issues with insurance, the specialty pharmacy, and patient support programs
  • Work closely with the Reimbursement Team, PAMs, the hub, pharmacy, and the patient/family to case manage all steps required to gain access to therapy
  • Partner with Safety and Pharmacovigilance and report adverse events 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
  • Daily interaction with Clinical Science Associates (CSAs), Patient Access Managers (PAMs) and Regional Medical Directors (RMDs) to ensure current and accurate communication on the status of insurance approvals and reauthorizations
  • Assist in developing strategy, 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

Requirements

  • Bachelor’s Degree required.
  • 5+ years of experience in the pharmaceutical industry.
  • 2+ years prior experience as a Case Manager.
  • Scientific or nursing background a plus.
  • 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.
  • Up to 20% travelrequired.
  • Proficient in Microsoft Office.
  • Professional demeanor.
  • Self-starter attitude.
  • Strong interpersonal skills.
  • Excellent written and verbal communication skills.

Essential Core Competencies:

  • Action Oriented
  • Problem Solving
  • Organization
  • Functional/Technical Skills
  • Priority Setting
  • Drive for Results
  • Strategic Agility
  • Intellectual Horsepower
  • Dealing with Ambiguity

Essential Behaviors:

  • Integrity and Trust
  • Composure
  • Standing Alone

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