Case Manager

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Inizio Engage

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5001 - 10000 Mitarbeiter

💼 Beratung

📣 Marketing

🏥 Gesundheitswesen

Consulting • Marketing • Healthcare

Inizio Engage ist ein Unternehmen, das mit Kunden im Gesundheitswesen und darüber hinaus zusammenarbeitet, um strategische, kommerzielle und kreative Engagement-Lösungen zu schaffen. Durch den Einsatz fortschrittlicher Analysen, einzigartiger Methoden und eines Teams von über 5. 000 Experten weltweit konzentriert sich Inizio Engage darauf, Entscheidungsprozesse zu optimieren, Patientenlösungen zu verbessern und medizinische Fachkräfte zu fördern. Das Unternehmen entwirft Erlebnisse, die dauerhafte Veränderungen inspirieren, Kulturen bereichern und die Unternehmensleistung verbessern. Sie sind spezialisiert auf Bereiche wie Medical Affairs, Patientenlösungen und Omnichannel-Kommunikation, mit dem Ziel, weltweit bessere Gesundheitsentscheidungen und Behandlungsergebnisse zu fördern.

Beschreibung

• Manage assigned patient cases from referral through therapy initiation, ensuring timely, accurate, and compliant case progression • Conduct benefits investigations electronically or by calling the insurance company to determine coverage information, prior authorization requirements, and patient financial responsibility • Manage the prior authorization and appeals process, including obtaining plan-specific criteria and requirements, initiating, submitting, and tracking requests, and following up with plans, patients, and HCPs as needed to ensure timely outcomes • Identify and facilitate patient enrollment in financial assistance programs, including copay and patient assistance programs • Support communications with patients, healthcare providers, payers, and specialty pharmacies as needed • Provide education on insurance coverage, access pathways, and next steps in the treatment journey when needed • Collaborate with internal teams and external partners to ensure timely therapy initiation and adherence to service level agreements • Document all case activity accurately within HUB systems in compliance with SOPs and regulatory requirements • Monitor case progress and escalate complex reimbursement issues as needed • Response to incoming calls from patients/caregivers and prescriber’s offices and addressing or routing calls as needed • Support leadership with tracking and resolving escalations • Support quality initiatives, audits, and continuous process improvement efforts • Ensure compliance with HIPAA, privacy, and regulatory standards at all times

🎯 Anforderungen

• Bachelor’s Degree or equivalent experience preferred • Experience in patient access, HUB services, reimbursement support, specialty pharmacy, or healthcare case management preferred • Working knowledge of benefits investigation, prior authorization, appeals, and patient assistance programs • Strong communication and interpersonal skills with a patient-focused approach • Ability to manage a high volume of cases in a fast-paced environment while meeting service level expectations • Proficiency with CRM systems and Microsoft Office applications • Strong organizational, analytical, and problem-solving skills • Ability to prioritize workload and manage multiple tasks effectively

🏖️ Vorteile

• Competitive pay that recognizes your experience, expertise, and impact • Comprehensive benefits including medical, dental, and vision coverage; accrued paid time off; 401(k) with company match; disability and life insurance; and paid maternity and paternity leave • Company-paid holidays so you can rest, recharge, and focus on what matters most • Recognition programs, contests, and awards that celebrate your contributions • Continuous growth opportunities through learning, leadership development, and career advancement support • A collaborative culture where your ideas are valued and your work makes a difference