Associate Director, Patient Services and Distribution Case Management
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Job Description
Case Manager supporting myBeOne Patient Support Program and specialty pharmacy distribution network. Engaging with patients, healthcare providers, and internal stakeholders to facilitate therapy access.
Responsibilities:
- Communicates with Patients, Caregivers, HCP’s throughout the patient journey as needed/directed by internal stakeholders to reduce/remove barriers to access therapy
- Proactively review all active patient cases to increase time-to-fill opportunities
- Review cases within internal database to ensure patients are placed in correct statuses based on knowledge and conversations with key partners (HUB and Specialty Pharmacies)
- In conjunction with Sr. Director of Patient Services and Sr. Director of Distribution/Trade Relations facilitate frequent calls with myBeOne, Corporate Account Directors, Field Account Managers, and Specialty Pharmacy Partners to understand patient journey and access specific patient therapy status/questions
- Triage/troubleshoot and resolve initial/on-going reimbursement issues by working with all relevant partners (step-edits, prior authorizations, denials, appeals, re-authorizations)
- Acts as the liaison between healthcare provider offices/internal customers and myBeOne Support Program/Specialty Pharmacies when needed (case/shipment delays, case status updates and case escalations)
- Partner with Commercial Operations and Data Analytics to proactively identify any data issues and to assess trends proactively
- Proactively partner with Field Sales Account Managers and Corporate Account Directors to present myBeOne Patient Support Program offerings and distribution model overview to various HCP stakeholders
- Utilize all available tools and resources to ensure patient missing information is not an obstacle to initiating therapy
- Will be primary contact for myBeOne Oncology Nurse Advocates for unsuccessful missing information retrieval or other information that could be causing a delay
Requirements:
- BS Degree with 5+ years’ experience in the pharmaceutical industry (Patient Services, Vendor Management, Specialty Pharmacy Operations)
- Experience supporting oral oncolytic via multiple distribution channels
- Prior reimbursement experience with the ability to research, resolve, and communicate complex case/reimbursement scenarios to patients, caregivers, HCP’s, field sales, FMAD, and CADs
- Experience with understanding benefits, access, and coverage from health insurance carriers
- Proficiency in payer coverage policy interpretation (commercial and government)
- Ability to multitask, prioritize, problem solve and manage communication with Oncology Nurse Advocates, Specialty Pharmacies, Corporate Account Directors, Field Market Access Directors and Account Managers across multiple geographies and time zones
- Cross functional collaboration to foster case resolution and case pull through
- Strong verbal and written communication skills
- Ability to handle sensitive PHI information
- Have strong attention to detail, analytical, investigation and critical thinking skills
- Ability to navigate missing information with HCP’s, Patients, myBeiGene, and Specialty Pharmacies
- Ability to work various shifts from 8-8 EST based on business need
- Strong data entry skills
- Knowledge of medical terminology
- Computer Proficiency
Benefits:
- Medical
- Dental
- Vision
- 401(k)
- FSA/HSA
- Life Insurance
- Paid Time Off
- Wellness
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