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Associate Case Manager

fvjdnwvwi7yecmymd9si3it1ointo80348emvd7mgqh749rpbe3n811jnfkeb228 · 30+ days ago

Cambridge, MA, US

$88k+
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Full-time

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Job Responsibilities/Department description:
Reimbursement Expertise (National & Regional Levels)

Establish and maintain a strong understanding of Sanofi Renal's product reimbursement though Medicare Part D, state Medicaid, and government and commercial prescription drug plans.
Keep current on all available Sanofi Renal Patient Assistance Programs, State Pharmacy Assistance Programs (SPAPs), and government and independently sponsored alternative funding programs.
Process a high volume of assistance requests received from healthcare providers and enter information into Sales Logix database in a timely and accurate manner.
Perform Verification of Benefits (VOBs) for patients who are clinically appropriate for Sanofi Renal products and enter information information into Sales Logix database in a timely and accurate manner.
Provide appropriate information to patients, their families, physicians, health care professionals, and insurance carriers on the coverage and benefits of Sanofi Renal products.
Facilitate Prior Authorizations, Formulary Exceptions, and/or other step edit requirements for Sanofi Renal Products.
Collaborate with Renassist team members, professionals, and insurance companies to troubleshoot and resolve reimbursement-related issues.

Relationship Building & Customer Service

Initiate and maintain strong working relationships with key stakeholders at physician offices and dialysis centers to facilitate effective case management. Includes, but is not limited to: renal dieticians, social workers, physicians, nurses, facility administrators and medical assistants.
Answer and address calls from the Renassist Helpline; document all pertinent information on callers into SalesLogix database.
Interact via phone with pharmacies, insurance companies, professionals, and Renal Business Unit colleagues.
Partner with internal Renassist counterparts to effectively manage regional reimbursement needs.
Communicate results of Verification of Benefits to Clinical Science Specialists and work as a team to ensure patients' access to therapy.
Limited travel may be required for National, Zone, and Regional meetings.

Workload Management

Required to manage a high volume of external customer assistance requests.
Expected to review assistance request results with customers and Clinical Science Specialists.
Provide customer follow up to facilitate successful transitions from Sanofi free drug to obtaining drug through new insurance prescription drug plans.
Assist team with overflow of work when required.

Perform in a Regulated Environment

Securely store and maintain patient records while complying with HIPAA regulations.
Comply with all state and federal healthcare and pharmaceutical laws and regulations.

Work with customers and coworkers in a professional and ethical manner.
Skills:
Skills Required:

Strong relationship building skills with internal and external customers.
Ability to overcome product access & reimbursement obstacles to directly impact patient care.
Effective workload management.
Ability to multitask and prioritize tasks independently.
Exceptional customer service.
Strong problem solving & decision making skills

Education:
Working knowledge of insurance benefits. Experience working in a team environment. Ability to work independently.
Preferred Qualifications:
Bachelor's degree, 3-5 years professional experience or Master's and 1-3 years. Ability to multitask, developed customer service skills, can accurately identify the needs of the customer, obtains a comprehensive understanding of Renassist's access and patient assistance services, well organized, efficient, consistently meets established deadlines, strong attention to detail, sense of urgency, strong collaboration skills. SalesLogix database experience a plus.

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Last updated on Jan 8, 2015

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