Case Manager 1
Case Manager 1
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Job Description
A career with EMD Performance Materials is an ongoing journey of discovery: our 57000 people are shaping how the world lives works and plays through next generation advancements in healthcare life science and performance materials. For more than 350 years and across the world we have passionately pursued our curiosity to find novel and vibrant ways of enhancing the lives of others. EMD Performance Materials is a business of Merck KGaA Darmstadt Germany.
This role does not offer sponsorship for work authorization. External applicants must be eligible to work in the US.
The Case Manager plays an integral role within EMD Seronos Patient Support Services Call Center MS LifeLines (MSLL) as part of the overall patient support program function within the Neurology & Immunology Therapeutic area.
The Case Manager will be directly responsible for facilitating access to EMD Serono products by providing patient access and reimbursement assistance as well as support for patients family members caregivers nurses physicians pharmacists and internal cases will be handled with personalized attention and the utmost confidentiality.
In this role the Case Manager will address access related inquiries assess patients coverage options provide eligibility and benefit verification work with HCPs to secure insurance authorizations advocate for maximum reimbursement coverage and provide patient assistance for those in need of financial support.
- Consistently provide a high level of customer service to both internal (sales force field patient support nurses) and external customers (patients physicians pharmacies insurers).
- Maintain accountability for daytoday patient case management activities workload and overall workflow.
- Manage tasks and activities in a timely manner within assigned geographic area to ensure a high level of patient and physician satisfaction
- Provide feedback to patient or provider on services offered and share unique situations/issues to ensure common response from patient support services.
- Provide feedback to patients or provider relative to insurance coverage with certain carriers and/or plans.
- Work on patients behalf to identify and assess reimbursement coverage options for those with insurance and to coordinate and/or investigate financial options for those without insurance.
- Work with third party vendors responsible for benefits verification and coverage requests to ensure information obtained is accurate and timely.
- Work with physician offices and/or pharmacies to facilitate the process of obtaining prior authorization from third party payers in order to maximize patients access to treatment.
- Help support the appeal process with consent from the patient caregiver and/or the provider
- Manage and maintain productive relationships with patients and their HCPs to ensure maximum process efficiency.
- Deliver presentations regarding patient support options to providers offices where appropriate and consistent with compliance guidelines.
- Align with managed care account managers and market access colleagues at the regional level to maintain a knowledge regarding Payors Pharmacies and maintain a working knowledge regarding formulary opportunities or challenges.
- Maintain database for recording managing and monitoring patient activities for those requiring access support.
- Upon request provide feedback and data on territory performance payers and HCP relationships to departmental manager
- Maintain a collaborative approach with members of call center team in order to offer the best possible outcome for all customers.
- Demonstrate the utmost sensitivity and confidentiality to information while maintaining a high level of professionalism.
- Assume additional projects on an as needed basis.
- Ensure continued education and training is met in order to maintain technical expertise in the assigned therapeutic area and to keep current on approved product information and promotional items.
Who You Are:
Basic Qualifications:
- High School Diploma or GED Equivalent
- 2 years of reimbursement and customer care experience in a medical health insurance or in a pharmacy technician capacity
Preferred Qualifications:
- Associates Degree or Bachelors Degree
- Bilingual capability
- Normal office duties.
RSRPM
What we offer: With us there are always opportunities to break new ground. We empower you to fulfil your ambitions and our diverse businesses offer various career moves to seek new horizons. We trust you with responsibility early on and support you to draw your own career map that is responsive to your aspirations and priorities in life. Join us and bring your curiosity to life!
Curious Apply and find more information at
The Company is an Equal Employment Opportunity employer. No employee or applicant for employment will be discriminated against on the basis of race color religion age sex sexual orientation national origin ancestry disability military or veteran status genetic information gender identity transgender status marital status or any other classification protected by applicable federal state or local law. This policy of Equal Employment Opportunity applies to all policies and programs relating to recruitment and hiring promotion compensation benefits discipline termination and all other terms and conditions of employment. Any applicant or employee who believes they have been discriminated against by the Company or anyone acting on behalf of the Company must report any concerns to their Human Resources Business Partner Legal or Compliance immediately. The Company will not retaliate against any individual because they made a good faith report of discrimination.
Required Experience:
Manager
Employment Type
Full Time
