Case Management Specialist – Hybrid Role

Case Management Specialist – Hybrid Role

Requirements

• Bachelor’s Degree required.
• 3-5 years of patient-facing or high touch customer interaction experience required.
• Bi-lingual; Spanish language skills
• Excellent written and oral communication, mediation, and problem-solving skills, including the ability to connect with patients, caregivers, and providers.
• Strong people skills that demonstrate flexibility, persistence, creativity, empathy, and trust.
• Robust computer literacy skills including data entry and MS Office-based software programs.
• Possesses strong business acumen and strategic thinking skills.
• Ability to identify and handle sensitive issues, working independently and collaboratively within teams.

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.
• 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 healthcare 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 specific issues and develop action plans accordingly. Demonstrates accountability for action plan execution, and energetically drives for success and results.
• Establish and maintain professional and effective relationships with all internal and external customers and stakeholders, including but not limited to case management team and patient support services colleagues, medical, sales, market access, insurance companies, specialty pharmacies, infusion site staff and office coordinators.
• Attend patient meetings, site visits/calls, conferences, and trade shows to educate individuals regarding services and other approved case management topics. Represent Sanofi in all venues in a professional manner.
• Raise own performance expectations and goals to support the account teams demonstrating personal and team growth.
• Demonstrate and maintain a high level of business acumen, understanding of Sanofi’s business model, and the role of the case manager and patient support services team in commercializing the business and driving initiatives to meet goals.
• Demonstrate innovation by consistently monitoring systems, processes, and potential care gaps, offering new ideas and solutions to elevate the support program.
• Effectively share reimbursement and other knowledge with PSS members through orientation training, case studies, consultation for complex cases, and special projects as requested.
• Consistently maintain and document accurate data, including insurance, coverage approvals, on-going coverage requirements, and all patient and provider interactions.
• Proficient in use of CRM tool to document work. Consistently leverage CRM reporting tools and data analytics to make strategic territory decisions while prioritizing patient and customer needs.
• Utilize professional communication to foster strong working relationships with internal and external colleagues.
• Provide caseload coverage outside of assigned territory as needed.

Preferred Qualifications

• In-depth understanding of health insurance benefits, relevant state and federal laws and insurance regulations strongly preferred.
• Salesforce CRM experience
• Direct experience in the case management, insurance, or healthcare systems fields
• Pharma/biotech patient services experience