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Case Manager, Reimbursement
United Biosource Corporation
10 hours ago
Full-time
Remote
Worldwide
Social Worker
As a pharmaceutical support industry leader, UBC is devoted to empowering health
solutions for a better tomorrow. We take pride in improving patient outcomes and
advancing healthcare. At UBC we provide services to enhance the entire drug
development process and commercialization lifecycle - From clinical trial
support to real-world evidence generation.
Embark on a rewarding career journey with UBC! Grow your career while making a
meaningful impact on the world around you. UBC fosters a culture built on our
Core Values being: Collaborative, Conscientious, Curious, Consultative, and
Compassionate. We believe in an inclusive workplace that fosters creativity.
If you are seeking a career that will challenge, inspire, and reward you, join
us at UBC!
--------------------------------------------------------------------------------
Case Manager, Reimbursement
Shifts: This position supports business operations between 8:00 AM and 9:00 PM
Eastern Time. Candidates must be available to work a full-time assigned shift
within these hours. Examples of potential schedules include:
* 8:00 AM – 5:00 PM ET
* 9:00 AM – 6:00 PM ET
* 10:00 AM – 7:00 PM ET
* 11:00 AM – 8:00 PM ET
* 12:00 PM – 9:00 PM ET
Assigned schedules are determined based on business and client needs. Candidates
residing outside of the Eastern Time Zone are welcome to apply but must be able
to work their assigned shift based on Eastern Time business hours.
Brief Description:
The primary purpose of this position is to provide day-to-day case management
oversight and coordination of assigned caseload to ensure parties responsible
for tasks are completing them timely, as well as act as a primary resource for
patients, healthcare providers and field reimbursement. The Case Manager is
responsible for ensuring prior authorizations, reauthorizations and appeals are
obtained in a timely manner, as well as ensuring accurate documentation of payer
information and patient status. In addition, the Case Manager is responsible for
completing a pre-screen to determine eligibility for additional services such as
injection services, co-pay mitigation, and patient assistance programs (PAP), if
applicable.
Specific job duties:
* Provide day-to-day oversight and coordination of caseload to ensure all case
elements and tasks are completed timely and ensure cases move through the
process as required.
* Act as single point of contact responsible for prior authorization and appeal
processing communications to patients, healthcare providers, field
reimbursement representatives and other external stakeholders.
* Communicate patient benefits and responsibility timely and accurately.
* Assess and refer patients appropriately for special programs/services when
appropriate.
* Performs quality checks on cases and report trends to leadership.
* Responsible for good housekeeping techniques, adhering to quality and
production standards while complying with all applicable company, state and
federal safety and environmental programs and procedures.
* Troubleshoot complex cases, spanning multiple disease-states, while
interfacing with key stakeholders (internal/external) to ensure optimal start
to therapy
* Report Adverse Drug Events that have been experienced by the patient in
accordance pharmaceutical requirements.
* Recognize a product quality complaint and forward caller/written information
to a manufacturer.
* Other duties, as assigned
Desired Skills and Qualifications:
* Bachelor’s degree or six years of relevant working experience
* Two (2) or more years of relevant experience in pharmacy benefit management
preferred
* Medical Assistant, Social Worker or Senior Reimbursement Specialist
experience preferred
* Certification preferred but not required
* 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 along with the ability to
multi-task
* Ability to travel as required - This is primarily a remote position;
however, occasional travel may be required based on client, business, or
training needs. While travel is expected to be infrequent, candidates must be
willing and able to travel as needed. Travel requirements may vary depending
on the client program and business objectives.
Benefits:
At UBC, employee growth and well-being are always at the forefront. We offer an
extensive range of benefits to ensure that you have everything you need to
thrive personally and professionally.
Here are some of the exciting perks UBC offers:
* Remote opportunities
* Competitive salaries
* Growth opportunities for promotion
* 401K with company match*
* Tuition assistance (after 90 days of employment)
* Flexible work environment
* 20 days PTO
* Paid Holidays
* Employee assistance programs
* Medical, Dental, and vision coverage
* HSA/FSA
* Telemedicine (Virtual doctor appointments)
* Wellness program
* Adoption assistance
* Short term disability (after 90 days of employment)
* Long term disability
* Life insurance
* Discount programs
UBC is proud to be an equal opportunity employer and does not discriminate
because of race, color, sex, age, national origin, religion, sexual orientation,
gender identity and/or expression, status as a veteran, and basis of disability
or any other federal, state, or local protected class. We are committed to a
diverse, equitable and inclusive culture that fosters respect for each other,
our clients, and our patients.
solutions for a better tomorrow. We take pride in improving patient outcomes and
advancing healthcare. At UBC we provide services to enhance the entire drug
development process and commercialization lifecycle - From clinical trial
support to real-world evidence generation.
Embark on a rewarding career journey with UBC! Grow your career while making a
meaningful impact on the world around you. UBC fosters a culture built on our
Core Values being: Collaborative, Conscientious, Curious, Consultative, and
Compassionate. We believe in an inclusive workplace that fosters creativity.
If you are seeking a career that will challenge, inspire, and reward you, join
us at UBC!
--------------------------------------------------------------------------------
Case Manager, Reimbursement
Shifts: This position supports business operations between 8:00 AM and 9:00 PM
Eastern Time. Candidates must be available to work a full-time assigned shift
within these hours. Examples of potential schedules include:
* 8:00 AM – 5:00 PM ET
* 9:00 AM – 6:00 PM ET
* 10:00 AM – 7:00 PM ET
* 11:00 AM – 8:00 PM ET
* 12:00 PM – 9:00 PM ET
Assigned schedules are determined based on business and client needs. Candidates
residing outside of the Eastern Time Zone are welcome to apply but must be able
to work their assigned shift based on Eastern Time business hours.
Brief Description:
The primary purpose of this position is to provide day-to-day case management
oversight and coordination of assigned caseload to ensure parties responsible
for tasks are completing them timely, as well as act as a primary resource for
patients, healthcare providers and field reimbursement. The Case Manager is
responsible for ensuring prior authorizations, reauthorizations and appeals are
obtained in a timely manner, as well as ensuring accurate documentation of payer
information and patient status. In addition, the Case Manager is responsible for
completing a pre-screen to determine eligibility for additional services such as
injection services, co-pay mitigation, and patient assistance programs (PAP), if
applicable.
Specific job duties:
* Provide day-to-day oversight and coordination of caseload to ensure all case
elements and tasks are completed timely and ensure cases move through the
process as required.
* Act as single point of contact responsible for prior authorization and appeal
processing communications to patients, healthcare providers, field
reimbursement representatives and other external stakeholders.
* Communicate patient benefits and responsibility timely and accurately.
* Assess and refer patients appropriately for special programs/services when
appropriate.
* Performs quality checks on cases and report trends to leadership.
* Responsible for good housekeeping techniques, adhering to quality and
production standards while complying with all applicable company, state and
federal safety and environmental programs and procedures.
* Troubleshoot complex cases, spanning multiple disease-states, while
interfacing with key stakeholders (internal/external) to ensure optimal start
to therapy
* Report Adverse Drug Events that have been experienced by the patient in
accordance pharmaceutical requirements.
* Recognize a product quality complaint and forward caller/written information
to a manufacturer.
* Other duties, as assigned
Desired Skills and Qualifications:
* Bachelor’s degree or six years of relevant working experience
* Two (2) or more years of relevant experience in pharmacy benefit management
preferred
* Medical Assistant, Social Worker or Senior Reimbursement Specialist
experience preferred
* Certification preferred but not required
* 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 along with the ability to
multi-task
* Ability to travel as required - This is primarily a remote position;
however, occasional travel may be required based on client, business, or
training needs. While travel is expected to be infrequent, candidates must be
willing and able to travel as needed. Travel requirements may vary depending
on the client program and business objectives.
Benefits:
At UBC, employee growth and well-being are always at the forefront. We offer an
extensive range of benefits to ensure that you have everything you need to
thrive personally and professionally.
Here are some of the exciting perks UBC offers:
* Remote opportunities
* Competitive salaries
* Growth opportunities for promotion
* 401K with company match*
* Tuition assistance (after 90 days of employment)
* Flexible work environment
* 20 days PTO
* Paid Holidays
* Employee assistance programs
* Medical, Dental, and vision coverage
* HSA/FSA
* Telemedicine (Virtual doctor appointments)
* Wellness program
* Adoption assistance
* Short term disability (after 90 days of employment)
* Long term disability
* Life insurance
* Discount programs
UBC is proud to be an equal opportunity employer and does not discriminate
because of race, color, sex, age, national origin, religion, sexual orientation,
gender identity and/or expression, status as a veteran, and basis of disability
or any other federal, state, or local protected class. We are committed to a
diverse, equitable and inclusive culture that fosters respect for each other,
our clients, and our patients.