Senior Case Manager, Reimbursement

🔥 2 minutes ago

🇺🇸 United States – Remote

⏰ Full Time

🟠 Senior

👔 Manager

👻 Ghost score 10%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

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

Upload Resume

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

• 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 • Serve as a patient advocate and resource throughout the reimbursement process • Coordinate additional patient access services within program guidelines • Perform quality checks on cases and report trends to leadership • Troubleshoot complex cases spanning multiple disease states • Interface with internal and external stakeholders to ensure optimal start to therapy • Report Adverse Drug Events in accordance with pharmaceutical requirements • Recognize product quality complaints and forward information to the manufacturer • Assist case managers with prior authorization and appeal requirements, process questions, and escalations • Support at-risk patients and prescribers to mitigate lapses in therapy • Collaborate with senior case managers, managers, and the quality team on quality trends and process improvement initiatives • Prepare and present team huddles and client presentations, with a minimum of one presentation per month • Serve as an account manager for prescribers when assigned • Share best practices and territory trends with client field teams • Mentor and/or lead other case managers • Manage work in progress to acceptable quality and productivity standards • Perform other duties as assigned

🎯 Requirements

• Bachelor’s degree or six years of relevant working experience • Five (5) or more years of relevant experience in pharmacy benefit management, specialty pharmacy or patient support/access (HUB) services preferred • Three (3) or more years of relevant experience in pharmacy and/or medical benefit verifications, prior authorization and/or appeals required • 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 • Must possess a strong critical thinking skillset • Ability to multi-task • Experience with Pharmacy Benefit Management, complex reimbursement case management, and pharmacy reimbursement hubs • Ability to work with patients, healthcare providers, field reimbursement representatives, prescribers, and other stakeholders • Ability to comply with applicable company, state and federal safety and environmental programs and procedures

🏖️ Benefits

• Remote opportunities • Competitive salaries • Growth opportunities for promotion • 401K with company match • Tuition reimbursement • Flexible work environment • 20 Days 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