Pharma Support RN, 11AM-8PM or 12PM-9PM ET

🔥 1 minute ago

🇺🇸 United States – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

👻 Ghost score 10%

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UBC

WebsiteLinkedInAll Job Openings

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

• Perform as a Clinical Case Manager supporting healthcare providers and patients through telephonic support for client-funded contracts • Provide telephonic support to healthcare providers • Review payer-specific coverage criteria • Complete clinical reviews of prior authorization and appeal submissions • Provide written communication using client-approved program resources • Build and develop customer relationships and support activities facilitating patient access • Adhere to program-specific contractual agreements and company practices • Demonstrate clinical competency regarding reimbursement, products, and medical records • Review and train team members on clinical concepts • Troubleshoot complex cases, identify disease-state trends, investigate data, and resolve escalated reimbursement issues • Review payer product coverage criteria and denial letters for documentation required for coverage determinations • Communicate with healthcare providers regarding payer coverage criteria and missing submission information • Handle inbound and outbound inquiries, collect data, document follow-up calls, patient inquiries, outcomes, clinical notes, and medical-record/chart reviews • Gather, analyze, and prepare data for Quarterly Business Reviews and client meetings • Participate in customer meetings and training sessions • Report adverse drug events according to manufacturer requirements • Attend manufacturer conferences, customer meetings, training, and Quarterly Business Reviews, including in-person events when requested • Complete special projects and other assigned duties

🎯 Requirements

• Minimum associate degree and professional nursing license • Registered Nurse License in good standing in the state in which you work • Compact State License, where applicable, or willingness to obtain one when eligible • California RN license through endorsement upon hire and willingness to obtain additional state licenses as required • Previous experience in the PBM and/or healthcare industry • 2+ years’ experience in a customer service setting, preferably in a call center environment • Competent ability to research, analyze, prepare reports, and document clearly • Proficient in Microsoft Office applications, specifically Excel • Ability to handle a fast-paced environment and multitask • Strong written and verbal communication skills • Advanced problem-solving and troubleshooting skills, including critical thinking • Strong attention to detail and relationship-building skills • Ability to train other team members • Availability for assigned 11:00 AM–8:00 PM ET or 12:00 PM–9:00 PM ET shift • Availability for rotating Saturday shifts and select holidays • No planned time off during the 8-week training period • Willingness to travel occasionally for training, client meetings, conferences, team meetings, or other business events

🏖️ Benefits

• Remote opportunities • Competitive salaries • Growth opportunities for promotion • 401K with company match • Tuition reimbursement after 90 days of employment • 20 days PTO • Paid Holidays • Employee assistance programs • Medical, Dental, and vision coverage • HSA/FSA • Telemedicine /Virtual doctor appointments • Wellness program • Adoption assistance • Short term disability after 90 days of employment • Long term disability • Life insurance • Discount programs • Saturday hours paid as overtime • One week of business-paid travel during training