Case Manager, Reimbursement

🔥 6 minutes ago

🇺🇸 United States – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

👔 Manager

👻 Ghost score 10%

infoinfo
Apply Now
Find Similar Remote Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Logo of UBC

UBC

1001 - 5000 employees

Founded 2003

🏥 Healthcare

💼 Consulting

🧬 Biotechnology

Healthcare • Consulting • Biotechnology

UBC is a company dedicated to improving patient outcomes by connecting specialty therapies to patients in need. They provide modern and customized solutions focusing on access, safety, and evidence generation for biopharmaceutical products. UBC specializes in evidence development, risk management, and patient access, utilizing real-world data and innovative technologies to optimize the healthcare journey and ensure effective medication use.

📋 Description

• Provide day-to-day case management oversight and coordination of assigned caseload • Ensure case elements and tasks are completed timely and cases move through the process as required • Act as the single point of contact for prior authorization and appeal processing communications • Communicate with patients, healthcare providers, field reimbursement representatives, and other external stakeholders • Communicate patient benefits and responsibility accurately and timely • Assess and refer patients for special programs and services • Perform quality checks on cases and report trends to leadership • Adhere to quality and production standards and applicable safety and environmental procedures • Troubleshoot complex cases spanning multiple disease states • Interface with internal and external stakeholders to ensure optimal start to therapy • Report patient Adverse Drug Events according to pharmaceutical requirements • Recognize product quality complaints and forward relevant information to the manufacturer • Perform other duties as assigned

🎯 Requirements

• 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 • Certification preferred but not required • Proficient in Microsoft Office applications • Knowledge of medical and claims processing terminology • Excellent written/verbal communication to include providing clear instructions • Monday–Friday availability, 11AM–8PM EST

🏖️ Benefits

• Remote opportunities • Competitive salaries • Growth opportunities for promotion • 401K with company match • Tuition reimbursement • Flexible work environment • PTO (Paid Time Off) • 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

Apply Now

Similar Jobs

🔥 3 hours ago

EXL

10,000+ employees

🏥 Healthcare

🛡️ Insurance

📦 Logistics

DRG Quality Manager leading MS-DRG and APR-DRG quality reviews for EXL’s healthcare clients. Supervising analysts, ensuring coding accuracy, compliance, SLAs, and process improvement.

🇺🇸 United States – Remote

💵 $100k - $120k / year

💰 $2M Venture Round on 2015-01

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

🔥 4 hours ago

Alliant Insurance Services

10,000+ employees

🛡️ Insurance

🤝 B2B

💼 Consulting

Brand Experience Manager leading internal conferences, client programs, and brand activations for a professional services company. Managing strategy, events, budgets, KPIs, and cross-practice growth.

🇺🇸 United States – Remote

💰 $690M Debt Financing - Alliant Insurance Services on 2019-10

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

🔥 6 hours ago

CVS Health

10,000+ employees

🏥 Healthcare

⚕️ Healthcare Insurance

🛒 Retail

RN Case Manager coordinating clinical care, benefits, and wellness outcomes for CVS Health members. Remote New Jersey role with occasional field-based case management travel.

🔥 7 hours ago

OmniMax

1001 - 5000

🏗️ Construction

🏭 Manufacturing

🔧 Hardware

Regional Service Manager supporting Gibraltar building products at Home Depot stores. Driving merchandising excellence, retailer relationships, product training, and regional sales growth.

🔥 7 hours ago

OmniMax

1001 - 5000

🏗️ Construction

🏭 Manufacturing

🔧 Hardware

Regional Service Manager supporting Gibraltar building products merchandising, training, and sales growth at Home Depot. Managing Atlanta-area retail relationships, audits, and regional execution.