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Case Manager (Non-Clinical)

5+ years
Not Disclosed
10 Dec. 5, 2024
Job Description
Job Type: Full Time Education: B.Sc./ M.Sc./ M.Pharm/ B.Pharm/ Life Sciences Skills: Causality Assessment, Clinical SAS Programming, Communication Skills, CPC Certified, GCP guidelines, ICD-10 CM Codes, CPT-Codes, HCPCS Codes, ICD-10 CM, CPT, HCPCS Coding, ICH guidelines, ICSR Case Processing, Interpersonal Skill, Labelling Assessment, MedDRA Coding, Medical Billing, Medical Coding, Medical Terminology, Narrative Writing, Research & Development, Technical Skill, Triage of ICSRs, WHO DD Coding

Company Description
At EVERSANA, we take pride in being a certified Great Place to Work globally. Our vision is to create a healthier world, driven by a team of over 7,000 employees across the globe. We deliver next-generation commercialization services to the life sciences industry, serving over 650 clients ranging from innovative biotech startups to established pharmaceutical companies. Our solutions help bring innovative therapies to market and support patients who depend on them. We are grounded in our cultural beliefs and aim to create an inclusive, impactful workplace where diversity in backgrounds and experiences is embraced. Join us in making a difference every day.

Job Description
We are looking for a Case Manager / Patient Support Navigator (CM-PSN) to play a crucial role in front-line patient and caregiver support. The CM-PSN serves as a resource for Social Determinants of Health (SDOH) for patients and their families throughout the patient assistance journey, offering patient-centered support and acting as a liaison between patients, caregivers, healthcare providers, and our internal and external teams.

Key Responsibilities:

  • Serve as a patient advocate, educator, and single point of contact for patients and caregivers.
  • Field incoming calls from patients, caregivers, and providers, triaging as needed and routing to the appropriate team.
  • Provide reliable information about resources available to patients.
  • Assess patient needs during the initial welcome call, matching them to the appropriate resources and program support.
  • Adhere to business rules, policies, and SOPs to ensure compliance.
  • Identify barriers related to SDOH and refer patients to aligned resources.
  • Conduct benefit investigations and collaborate with insurance companies for prior authorizations.
  • Manage data entry related to patient support programs and assist with benefit investigations.
  • Collaborate with internal teams to ensure timely patient service.
  • Participate in department projects and ensure excellence in patient support.

Job Expectations:

  • Demonstrate accountability and responsibility for job tasks.
  • Foster a collaborative, team-oriented attitude.
  • Exhibit professionalism, ethical behavior, and effective communication.
  • Ability to multitask, problem-solve, and work independently in a fast-paced environment.
  • Maintain a high level of attendance and compliance with online training.
  • Proficient in Microsoft Word, Excel, and PowerPoint.
  • Demonstrate compassion and empathy toward patients.

Preferred Qualifications:

  • Experience in patient support, call centers, reimbursement, or oncology.
  • Knowledge of medical coding, coverage, policy, and payment.

Additional Information:

  • Hourly Rate: $24.00/hour (subject to location and experience).
  • EVERSANA is committed to ensuring a fair, transparent recruitment process and is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.