Sr. Case Manager, Patient Services

Job Description

Position Summary:

The Senior Case Manager, Patient Services will educate customers about our products, to provide services that facilitate access to our treatments through the removal of non-clinical challenges to ensure safety and compliance with FDA and other regulatory standards. Biogen values team players who are accountable, customer focused, ethical, inclusive, and agile in the ways they work. Our goal is to Care Deeply, Work Fearlessly, and Change Lives. 

The Senior Case Manager is responsible for acting as a liaison between patients and healthcare providers, as well as other internal and external partners by helping them navigate the complex process to supporting access to prescribed medication.  The Senior Case Manager role will require a high level of ownership, problem solving, and empathetic patient focused care from case initiation to case closure. Additionally, this role will utilize strong interpersonal skills for the support and education of patients in their disease state, understanding of medical and pharmacy benefits, Biogen product education and the offering of service option explanations. 

Primary Responsibilities:
•    Build trusted relationships with patients and healthcare providers, internal work group partners through proactive communication, timely and accurate execution of deliverables and demonstrated relentless passion for helping patients
•    Leverage thorough understanding of program services to align support provided based on the unique needs of each patient
•    Deliver personalized case management to patients and Healthcare Providers including inbound and outbound communication to patients and HCP’s regarding solutions to non-clinical challenges to access therapy
•    Provide personalized reimbursement support to patients, healthcare providers and Biogen field support including benefit investigations, prior authorization information, denial appeals, determining financial qualifications for assistance programs and assisting patients, healthcare providers or other stakeholders through resolution by using critical thinking skills and knowledge of the program services, coverage and industry rules and standards 
•    Conduct necessary benefits, coverage, and payer research/investigations to ensure appropriate resources, compliance with payer appeal policies, practices, and timelines
•    Adhere to all standard operating procedures and departmental procedures
•    Ability to travel up to 20%
•    Meet and exceed performance metrics and quality standards to ensure desired customer experience and business objectives are achieved
•    Other duties as assigned

Competencies critical to the role: 
•    Strong interpersonal skills; listens well; expresses ideas fluently and logically and is open to input
•    Professional telephone etiquette; effective verbal and written communication skills 
•    Service oriented; anticipates, recognizes, and meets the needs of others, including patients, providers, field-based team members, peers and other stakeholders.
•    Pursues goals persistently despite obstacles and setbacks, achieves results
•    Persuades and influences without authority; fosters an exchange of ideas and support
•    Detail oriented, accurate and complete; investigational and problem-solving skills 
•    Ability to manage time appropriately and have strong organization skillset 
•    Understanding of Standard Operating Procedures and adaptive, energetic, and comfortable with process improvement and change management
•    Ability to identify trends in assigned work and proactively communicates to leadership and partners

Qualifications

Required Skills:

•    A minimum of 3 years of customer service, patient services, case management, or related experience in healthcare environment preferred 
•    Proficient in all aspects of reimbursement (i.e., benefit investigations, payer reimbursement policies, regulatory and administrative rules) and understands how to access these reimbursement and funding resources
•    Must have excellent knowledge of the managed care industry, including government payers and procurement
•    Demonstrated investigational and analytical skills 
•    Ability to utilize strong interpersonal skills that will allow for the support and education of patients, understanding of medical benefits, and communicating support program options that will drive successful outcomes for patients
•    Work effectively under pressure and prioritize tasks in a fast-paced environment
•     Ability to work collaboratively in a team structure with a desire to work with and assist peers, prescribers, sales team members, patients, and business partners
•    Ability to assist peers as needed in order to maintain performan