Case Manager, Reimbursement

🕒 Junho 1

🐊 Florida – Remoto

🐊 Florida – Remote

⏰ Tempo Integral

🟢 Júnior

🟡 Pleno

👔 Gerente

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UBC

SiteLinkedInTodas as Vagas

1001 - 5000 funcionários

Fundada em 2003

🧬 Biotecnologia

⚕️ Seguro de Saúde

💊 Farmacêutico

Biotechnology • Healthcare Insurance • Pharmaceuticals

A UBC é uma empresa dedicada a melhorar os resultados dos pacientes, conectando terapias especializadas aos pacientes que delas necessitam. Eles oferecem soluções modernas e personalizadas, focando em acesso, segurança e geração de evidências para produtos biofarmacêuticos. A UBC é especializada em desenvolvimento de evidências, gestão de riscos e acesso do paciente, utilizando dados do mundo real e tecnologias inovadoras para otimizar a jornada de saúde e garantir o uso eficaz de medicamentos.

Descrição

• Provide day-to-day oversight and coordination of caseload to ensure all case elements and tasks are completed timely and ensure cases move through the process as required. • Act as single point of contact responsible for prior authorization and appeal processing communications to patients, healthcare providers, field reimbursement representatives and other external stakeholders. • Communicate patient benefits and responsibility timely and accurately. • Assess and refer patients appropriately for special programs/services when appropriate. • Performs quality checks on cases and report trends to leadership. • Responsible for good housekeeping techniques, adhering to quality and production standards while complying with all applicable company, state and federal safety and environmental programs and procedures. • Troubleshoot complex cases, spanning multiple disease-states, while interfacing with key stakeholders (internal/external) to ensure optimal start to therapy • Report Adverse Drug Events that have been experienced by the patient in accordance pharmaceutical requirements. • Recognize a product quality complaint and forward caller/written information to a manufacturer. • Other duties, as assigned.

🎯 Requisitos

• Bachelor’s degree or six years of relevant working experience • Two (2) or more years of relevant experience in pharmacy benefit management preferred • Medical Assistant, Social Worker or Senior Reimbursement Specialist experience preferred • Proficient in Microsoft Office applications • Knowledge of medical and claims processing terminology • Excellent written/verbal communication to include providing clear instructions

🏖️ Benefícios

• Remote opportunities • Competitive salaries • Growth opportunities for promotion • 401k with company match* • Tuition reimbursement • Flexible work environment • 20 Days PTO Annually (accrued) • Paid Holidays • Employee assistance programs • Medical, Dental, and vision coverage • HSA/FSA • Telemedicine (Virtual doctor appointments) • Wellness program • Adoption assistance • Short term disability • Long term disability • Life insurance • Discount programs