Case Manager
Case Manager (Contractor)
The Position:
Position requires working in the Portland office. Relocation / sponsorship assistance will not be provided.
The Access Solutions Case Manager acts as a liaison between patients, providers, distributors, and insurance carriers to assure services are provided in the least restrictive and least costly manner. The Case Manager reports to the Case Management & Reimbursement Supervisor and is an individual contributor.
Key Responsibilities/Accountabilities:
- Provide reimbursement support to patients, pharmacists, physicians, and internal sales force.
- Educate, inform, and assist patients (and their families) and providers to navigate through the reimbursement and appeal process for the assigned product.
- Identify barriers to reimbursement and continually identify and recommend program efficiencies to the Supervisor to promote a high quality of work by Access Solutions staff.
- Identify and facilitate referrals to alternative coverage options and financial assistance programs for patients who are under insured or require copy assistance.
- Establish relationships with appropriate stakeholders including internal & external partners.
- May conduct benefits coverage and payer research/investigations to ensure appropriate resources, compliance with payer appeal policies, practices, and timelines.
- Periodic mandatory overtime throughout the year is required in Access Solutions Operations. This may include, but is not limited to, high referral season (Blizzard, Enrollment renewal), new product or system launches, new line extensions, or any unexpected surge in volume or backlog situations. May include weekends as needed.
Competencies:
- Communication
- Inspiring and Influencing
- Teamwork and Collaboration
- Achieving Results
Recommended Skills and Experiences:
- Bachelor’s degree is preferred.
- 3 years of reimbursement experience preferred.
- Candidate must have excellent knowledge of the managed care industry, including government payers.
- Proficiency in all aspects of reimbursement (i.e., benefit investigations, payer reimbursement policies, regulatory and administrative rules).
- Understands reimbursement/funding resources and how to access these resources.
- Demonstrates effective problem-solving skills and provides excellent customer service.
- Excellent investigational and analytical skills with a proven ability to communicate effectively in both written and verbal format.
- Ability to work collaboratively in a team structure and responsibly delegate next steps to appropriate team members.
- Must be able to work effectively under pressure and prioritize tasks.
- Must be able to follow written Standard Operating Procedure.
Who We Are
A member of the Roche Group, Genentech has been at the forefront of the biotechnology industry for more than 40 years, using human genetic information to develop novel medicines for serious and life-threatening diseases. Genentech has multiple therapies on the market for cancer & other serious illnesses. Please take this opportunity to learn about Genentech where we believe that our employees are our most important asset & are dedicated to remaining a great place to work.
Genentech is an equal opportunity employer & prohibits unlawful discrimination based on race, color, religion, gender, sexual orientation, gender identity/expression, national origin/ancestry, age, disability, marital & veteran status. For more information about equal employment opportunity, visit our Genentech Careers page.