Band

Level 1

Job Description Summary

The Case Manager owns case processing steps for patient support services enrollments submitted by patients and healthcare professionals when initiating treatment of a Novartis therapy. Responsibilities include navigation through onboarding, [inbound/outbound] telephony interactions, resolving missing enrollment information, insurance verification, prescription triage, and enrollment into financial assistance programs as requested by the patient and their healthcare professional. Case Managers will also be working with cross-functional team members within Novartis Patient Support, where appropriate, to ensure continuity of information being shared with the healthcare professional and patients.

As a Case Manager, you may be assigned a specific territory to work within and partner with one or more Patient Navigators on management of specific patient cases. Expected scope of expertise for case management will include assessing requirements to progress cases, critically reviewing outputs of manual or auto-generated case activities for next steps, understanding eligibility requirements for available program offerings and enrolling where applicable, triaging outcomes to specialty pharmacies, interacting with payers for complex coverage cases, and management of information flow to internal partners for communication to HCPs and Sites of Care. Case Managers will possess critical thinking and communication skills, understanding key risk points in the patient journey and strive for continual development.



The Case Manager must have strong communication skills to converse with callers about the patient’s journey, reflecting a calm and reassuring tone, and be able to offer next steps in accordance with approved procedures. The Case Manager will possess an aptitude for learning, the ability to accept and implement constructive feedback, and a continual development mindset.

 

Job Description

Key responsibilities: 

• Learn and utilize protocols and business rules to respond to customer phone, fax, SMS / text, mail, and e-mail inquiries as well as other communication channels in a prompt and courteous manner 

• Professionally and compliantly interact with [patients, HCPs, caregivers, payers, relevant Novartis associates], and other external contacts during telephony interactions. 

• Ability to critically assess outputs of AI/e-tools utilized during the patient journey and manually address case completion needs 

• Full understanding of the patient journey and program eligibility criteria to identify and execute necessary next steps for case progression per program business rules 

• Compliantly interact with payers and insurance entities to obtain benefits and coverage exception statuses, where required 

• Identify and resolve complex interactions and/or cases involving missing enrollment information, insurance navigation, triage steps and financial assistance eligibility determinations 

• Provide clear summary of case actions, outputs and statuses for case handoffs and external communication by internal counterparts 

• Adhere to Service Level Agreements (SLAs), Key Performance Indicators (KPIs), productivity, and quality metrics 

• Leverage dual monitors and technological solutions to support Case Management activities 

• Accurately and concisely document all interactions via approved procedures 

• Promptly and courteously respond to tasks and notifications from PSC counterparts 

• As applicable, raise innovative ideas which will drive improved efficiency and effectiveness of customer service to Supervisors 

• Responsible for identifying and reporting adverse events via the established Novartis systems as per applicable processes 

 

Requirements:

• High School Diploma required, associate or BS/BA degree preferred 
• This job requires you live in either New Jersey or Arizona
• Ability to work the scheduled work hours, which generally will be a 9-hour shift with two paid rest breaks and an unpaid lunch break; Working schedule is either 8:00 am EST – 5:00 pm EST/9:00 am – 6:00 pm EST or 11:00 am EST – 8:00 PM EST 
• Minimum 3 years of relevant patient service support experience (such as Healthcare, Pharmaceuticals, Patient Services or Contact Center Experience) 

• Strong interpersonal, telephone and verbal communication skills, including the ability to project warmth and compassion while effectively and efficiently conveying information 

• Excellent written communication skills including the ability to interpret, capture and document the essence of and next steps for customer conversations in a clear and cogent way 
• Computer literacy in with data entry, video conferencing systems, and telephony/case management systems 
• Experience working with Salesforce or other CRM platforms 
• Bi-lingual, Spanish speaking preferred 

 

Salary Range

$57,800.00 - $107,300.00

 

Skills Desired

Customer Service, Customer Support, Data Entry, Finance, Inventory Control, Pharmaceutical Products, Workforce Management (WFM)