Case Management Specialist (REMOTE)

Job Title: Case Management Specialist

Location: US Remote, Cambridge, MA,

About the Job

Across the Rare Diseases our ‘one team, common goals, single mission’ approach is leading the way. 

This Rare Disease model highlights the need to reinvent and evolve the Case Management (CM) specialist role with more accountability, responsibility, and strategic intent than ever before. The new CM will be required to elevate performance, skills, knowledge, behaviors and contribute a critical component of our new play to win elite approach. 

We have elevated the CM role to include: Building expertise for 7 brands, 5 therapeutic areas, engage in account strategy and planning with galaxy and constellation teams (monthly), engage in launch preparations with insights and expertise, understanding market conditions that impact the patient journey (i.e. payer coverage, government, legislation, Pharma, industry, access), understanding rare competitive products, advise the cross functional teams on the patient perspective, consider the account perspective, and developing skills sets that will allow them to compliantly bring patient insights back to leadership reducing the need for external insights gathering. CM will communicate key performance indicators (KPIs) to measure success and impact (reported monthly). There will be a component of travel driven by the account needs, requests, and team decisions.

The Case Management Specialist will be responsible for supporting Rare Disease patients and families through comprehensive care coordination and case management expertise aligned to their assigned community territory.  This position will be utilized as a case management position throughout the country that will support open geographies. The role will involve different lengths of long-term and short-term coverage.

The CMS will develop and execute personalized care plans to identify and address barriers to treatment, foster ongoing relationships with patients, caregivers, healthcare providers, and other key stakeholders. The CMS proactively identifies and mitigates access barriers, coordinates with insurance providers, specialty pharmacies, and local resources as needed. Additionally, they assist in facilitating insurance approvals for both the product and administration, ensuring seamless collaboration across multiple functions to maintain a cohesive support network. The CMS works collaboratively in a team environment with internal cross-functional team members to help facilitate and optimize patient care. 

We are an innovative global healthcare company, committed to transforming the lives of people with immune challenges, rare diseases and blood disorders, cancers, and neurological disorders. From R&D to sales, our talented teams work together, revolutionizing treatment, continually improving products, understanding unmet needs, and connecting communities. We chase the miracles of science every single day, pursuing progress to make a real impact on millions of patients around the world.

Main Responsibilities:

• Act with a sense of urgency and purpose, lead the case management process, while balancing the needs of individual patients to align with the business objectives of Sanofi, and the Rare Disease organization.

• This position will be utilized as a case management position throughout the country that will support open geographies. The role will involve different lengths of long-term and short-term coverage.

• Assess individual patients’ access needs and develop an action plan that provides for the initiation and continuation of treatment. 

• Help facilitate insurance approval for Sanofi Rare Disease therapies.

• Educate patients, caregivers, health care providers, and others regarding insurance options, requirements or limitations, case management services, and steps needed to gain product and administration approval.

• Maintain comprehensive understanding of the reimbursement process, navigation of health care systems, billing/coding guidelines, insurance plans, payer trends, internal and external patient assistance programs, and related resources.

• Enroll patients who qualify into the appropriate financial assistance program as needed/required. 

• Maintain up-to-date knowledge of the resources available at the regional level as well as market landscape and apply this knowledge in ways that best supports patient access to therapy.

• Compliantly coordinate the exchange of patient-related information with internal and external stakeholders.

• Exhibit initiative and leadership within the cross-functional regional team. Able to consistently identify complex patient care gaps and develop action plans. Demonstrates accountab