Case Manager, West Coast

Overview

Alnylam (Nasdaq: ALNY) is delivering on a bold vision to turn scientific possibility into reality, with a robust RNA interference (RNAi) therapeutics platform. As the pioneer in RNAi and the leading RNAi therapeutics company, we have always been uncompromisingly dedicated to translating the breakthrough science into transformational medicines to help as many people as possible. Long focused on rare and genetic diseases, our scientific advances are now allowing us to bring the power of RNAi therapeutics to more prevalent diseases and as a result, we are beginning to recognize the full potential of this new class of medicines.

Alnylam is committed to its journey to become a top 5 independent, global biopharma company. We are already admired and recognized for our dedication to patients, company culture that empowers people to do their best work, track record of scientific innovation, social responsibility, and commercial excellence.

Founded in 2002, and headquartered in Cambridge, Mass., Alnylam has over 1,650 employees at work across the globe. We are seeking smart, passionate, “change the world” kind of people who are ready to say, “challenge accepted” to our mission. Thanks to the commitment of every employee globally, Alnylam is proud to have been recognized as one of Fast Company’s 2021 Best Workplaces for Innovators, a Science Magazine Top Employer three years in a row (2019-2021), a Boston Globe Top Places to Work seven years in a row (2015-2021), a Great Place to Work in Asia, Japan, Brazil, the U.K., Germany, Spain, Netherlands, Italy, France and Switzerland, Seramount’s 100 Best Companies (formerly Working Mother 100 Best Companies) and Best Companies for Dads, Bloomberg’s Gender Equality Index two years in a row (2021-2022), among others.  At Alnylam, we are committed to fostering a diverse, equitable and inclusive work environment, culture, and workforce, and we support several Employee Resource Networks.

Summary of Key Responsibilities

• Assess patients’ needs and develop action plans that provide for the initiation and
  continuation of treatment with Alnylam products while coordinating the exchange of all
  applicable patient-related information with appropriate internal and external stakeholders.
• Develops a comprehensive understanding of the reimbursement process, billing/coding
  nuances, insurance plans, payer trends, financial assistance programs, patient
  assistance programs, and related resources.
• Assists in obtaining insurance approval for Alnylam products, and proactively plans for
  maintenance of coverage by working with patients and their caregivers/families,
  healthcare providers, insurance companies, specialty pharmacies, and Alnylam colleagues.
• Understands the resources available in their specific region, and how they can be best employed to support patient care.
• Identifies complex patient-specific issues and develops and executes action plans accordingly.
• Maintains disease, reimbursement and insurance coverage expertise through continuing
  medical education and attendance at relevant conferences and other educational opportunities.
• Educates patients, caregivers, family members, health care providers, and others
  regarding insurance options and limitations, including PA and policy requirements necessary to initiate and maintain treatment, patient services’ offerings and relevant disease/product
  information as necessary.
• Fosters collaborative relationships with all internal and external customers including but
  not limited to Patient Education Liaisons, medical, sales, field reimbursement, corporate
  accounts, patient advocacy, insurance company case managers, specialty pharmacies,
  home health agencies, and office coordinators.
• Attend patient meetings and represent Alnylam at industry conferences, as needed
• Ensures compliance with all corporate and industry policies in collaboration with Alnylam Legal, Regulatory and Compliance.

Qualifications

• Bachelor’s Degree required. Health Care/Social Work/Nursing (or related field) a plus.
• 3+ years recent case management experience in the healthcare or pharmaceutical/biotech industry. Ultra-rare disease experience a plus.
• Experience should include but not be limited to home care management, case management review, utilization review, social service support, insurance reimbursement, patient assistance programs, or billing and coding.
• Knowledge of benefit verification and prior authorization process for infused and injectable products.
• Knowledge of private payer, Medicare, and Medicaid structure, systems, and reimbursement process required.
• Experience an