Make your mark for patientsThis position can be remote/virtual, based anywhere in the US supporting the East Coast time zone of the United States: (standard hours of operations 8:30am to 5:00pm EST). Role may require up to 15% travel to existing UCB sites.
We are looking for a Rare Disease Case Manager Specialist for the Eastern Region who is adaptable, highly collaborative and solution oriented to join us in our Patient Support Program.About the roleThe Rare Disease Case Manager Specialist serves as a subject matter expert on access & reimbursement who has extensive expertise in navigating insurance and access-related barriers. This role is designed to help patients gain access to prescribed UCB rare disease products and patient support, serving as the escalation point for difficult access related patient cases. This individual will share insights, and collaboratively coordinate services with internal and external program partners. This role requires significant knowledge in the market access and reimbursement landscape encompassing procurement, payer policies and coverage, benefit design, prior authorizations, appeals, exceptions, denials, coding and payer payment guidelines, site of care differences and nuances.
Who you'll work withThe Rare Disease Case Manager Specialist will engage and work directly with and across several different internal partners within their designated territory including Rare Reimbursement Executives, and Care Coordinators as well as cross functional partners including specialty pharmacies, HUB partners, payers, and as needed, physicians, office coordinators, nurses, pharmacists, and ancillary staff to support patients experiencing challenging reimbursement, access, and patient affordability matters.
What you'll do- Serve as expert on challenging market access patient cases specific to benefit verifications, product procurement processes, reimbursement information, billing, coding, and coverage details, after clinical decisions have been made by the prescriber.
- Coordinate the benefit verification referral process with UCB's service center(s) and deliver timely and accurate follow up to account stakeholders to help ensure patient access to UCB medicines.
- Provide appropriate Appeal & Claims Denial Support.
- Understand, provide quality control, communicate patient specific insurance coverage along with access and affordability options to team to support patients.
- Establish self as national and regional expert on payer trends, product access, and reporting reimbursement trends and/or delays (i.e., denials, underpayment, access delays, etc.).
- Coordinate and collaborate with UCB Rare Reimbursement Executives, Care Coordinators, specialty pharmacies, needed HCP (Health Care Professional) offices, infusion providers, other key personnel on complex cases which require strategic intervention.
- Manage and facilitate specialty pharmacy relationships, responsible for dispersing updates to team members and ensuring forward patient momentum.
- Ensure the understanding of the buy and bill reimbursement process, specialty pharmacies practices, field reimbursement support activities, and patient support programs.
Interested? For this role we're looking for the following education, experience and skills- Relevant Bachelors degree.
- 8-10 years of experience in pharma, biotech, or healthcare space.
- 5+ years of Case manager experience supporting market access, site of care selection.
- Excellent working knowledge of evolving reimbursement landscape and the practice management environment.
- Above-average skills with technology, including ability to quickly learn and accurately utilize contact center systems, CRM, and virtual platforms.
- Excellent virtual interaction and communication skills - both written and verbal.
- Demonstrated flexibility, adaptability, and the ability to prioritize tasks and meet customer demands.
Highly Desirable/Strongly Preferred:- Masters Preferred, or extensive relevant experience.
- Rare disease and/or infusion experience.
- Nursing degree/healthcare clinical experience.
- Experience in managing access complexities associated with a new to market medication.
- Experience with specialty pharmacy products / products acquired through specialty pharmacy networks or specialty distributors (buy and bill).
- Close connectivity to the everchanging payor medical benefit policy arena.
Expected Salary Range: $118,400 - $155,400 commensurate based on experience.
Are you ready to 'go beyond' to create value and make your mark for patients? If this sounds like you, then we would love to hear from you!
About usUCB is a global biopharmaceutical company, focusing on neurology and immunology. We are around 8,500 people in all four corners of the globe, inspired by patients and driven by science.
Why work for us?At UCB, we don't just complete tasks, we create value. We aren't afraid to push forward, collaborate, and innovate to make our mark for patients. We have a caring, supportive culture where everyone feels included, respected and has equitable opportunities to do their best work. We 'go beyond' to create value for our patients, and always with a human focus, whether that's on our patients, our employees or our planet. Working for us, you will discover a place where you can grow, and have the freedom to carve your own career path to achieve your full potential.
Learn more about sustainability at UCB and how it is integrated into our business approach.
UCB and its subsidiaries encourage diversity and inclusion in the workplace; we are an Equal Opportunity Employer. We do not discriminate on the basis of race/colour/religion/sex/national origin/veteran/disability/age/sexual orientation/gender identity.
Job Req: 86250
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