Posted to MedZilla on 8/18/2019


Takeda Pharmaceuticals

US-MA, Financial Case Manager SR0037167-MZ


 
 

Are you looking for a patient-focused, innovation-driven company that will inspire you and empower you to shine? Join us as a Financial Case Manager in our Lexington office.

At Takeda, we are transforming the pharmaceutical industry through our R&D-driven market leadership and being a values-led company. To do this, we empower our people to realize their potential through life-changing work. Certified as a Global Top Employer, we offer stimulating careers, encourage innovation, and strive for excellence in everything we do. We foster an inclusive, collaborative workplace, in which our global teams are united by an unwavering commitment to deliver Better Health and a Brighter Future to people around the world.

Here, you will be a vital contributor to our inspiring, bold mission.

Primary Role

Financial Case Management is the process of managing a patient s entire benefit need, which includes seeking alternative funding for other medical conditions a patient may have; assist in managing existing lifetime maximums and/or roll back benefits; identify additional insurance coverage options for various aspects of a patients care. The Financial Case Manager will be responsible for managing a group of patients that require specialized handling to ensure optimum coverage and financial assistance is in place for patients to begin and/or continue uninterrupted therapy to treat their medical condition(s). This position will be responsible for referring patients to external patient assistance vendors as well as manage the enrollment process for the PAP program, our free drug program to those patients deemed eligible. Shire offers patients several different forms of financial assistance including co-pay and deducible assistance, insurance premium assistance as well as assistance for other incidental medical expenses, including home nursing and specific travel related expenses.

To be viewed by their peers as a subject matter expert in all aspects of the case management process.

Essential Functions

Responsibilities:

  • Serves as a patient advocate by communicating with 501c3 organizations as well as any other organizations offering services to patients in need
  • Counsel patient/family on reimbursement options
  • Conducts research, manage patient records, and organizes documentation for the purposes of providing patient assistance
  • Guides patients through enrollment periods through both commercial and government payers as well as nonprofit organizations offering assistance
  • Collaborates with other members on the Patient Services Team for the purposes of updating patient status currently in Financial Case Management
  • Monitor and work with patients approaching Medicare eligibility to ensure appropriate placement in Parts A, B, & D plans as well as supplemental and Gap coverage where necessary
  • Coordinate and manage all eligible patient referral/enrollment into the Rare Disease Charitable Foundation/PAP Program
  • Maintain communication and interaction with patients and medical providers in order to address issues impeding optimum treatment goals
  • Research available commercial and government sponsored programs across all 50 states and Puerto Rico.
  • Provide back-up coverage for other Financial Case Managers
  • Attend patient meetings and represent the foundation at industry conferences
  • Be an on the floor leader
  • Become the subject matter expert for the group in a particular area (ex Medicare, healthcare reform, etc) and present this section to new hires during training process
  • Train Sales, Marketing and Patient Services
  • Manage products with Risk Evaluation and Mitigation Strategies (REMS).
  • Attend regional CMSA conference or national meetings related to all disease states we support (as needed)

Education & Experience Requirements:

  • BS/BA in life sciences/communications is preferred
  • Minimum of 5 years of prior case management experience (within last 2 years)
  • Minimum of 3 years of customer service experience

Key Skills and Competencies:

  • Prior reimbursement experience with ability to communicate complex reimbursement scenarios to patients and medical professionals.
  • Ability to multi task, problem solve and work independently
  • Individual must possess and portray strong emotional resilience
  • Individual must possess extraordinary positive attitude, exceptional listening skills, and strong verbal and written communication skills
  • Ability to handle sensitive information
  • Ability to work in a team environment with excellent communication skills
  • Presentation skills
  • Proficient in all MS Programs (MS, Access, Word, Outlook, and PowerPoint)
  • Customer Service Focus
  • Adapts to complex situations

Other Job Components

Complexity and Problem Solving:

  • Ability to problem solve complex scenarios and recommend solutions
  • Ability to problem solve complex reimbursement scenarios and recommend solutions
  • Ability to maintain composure and remain professional during difficult patient or medical calls

Internal and External Contacts:

  • Effectively communicate with both internal and external colleagues as well as management team when needed
  • Liaison with patients and families
  • Liaison with physicians and sites of care
  • Work with specialty pharmacy partners, nursing agencies and other 501c3 organizations
  • Work with Regional Business Managers, Patient Access Manager and Managed Care/Government Accounts team
  • Work as a coach to other case managers in the department

Travel Requirements:

  • 30% travel
  • Valid driver s license and/or Passport required

WHAT TAKEDA CAN OFFER YOU:

  • 401(k) with company match and Annual Retirement Contribution Plan
  • Tuition reimbursement Company match of charitable contributions
  • Health & Wellness programs including onsite flu shots and health screenings
  • Generous time off for vacation and the option to purchase additional vacation days
  • Community Outreach Programs

Empowering Our People to Shine

Discover more at takedajobs.com

No Phone Calls or Recruiters Please.

Notice to Employment / Recruitment Agents:

Employment / Recruitment agents may only submit candidates for vacancies only if they have written authorization to do so from Shire, a wholly-owned subsidiary of Takeda s Talent Acquisition department. Any agency candidate submission may only be submitted to positions opened to the agency through the specific Agency Portal. Shire, a wholly-owned subsidiary of Takeda will only pay a fee for candidates submitted or presented where there is a fully executed contract in place between the Employment / Recruitment agents and Shire, a wholly-owned subsidiary of Takeda and only if the candidate is submitted via the Agency Portal. Candidates submitted or presented by Employment / Recruitment Agents without a fully executed contract or submitted through this site shall not be deemed to form part of any Engagement for which the Agency may claim remuneration.

Equal Employment Opportunity

Shire, a wholly-owned subsidiary of Takeda, is an Equal Opportunity Employer committed to a diverse workforce. Shire, a wholly-owned subsidiary of Takeda, will not discriminate against any worker or job applicant on the basis of race, color, religion, gender, national origin, ancestry, age, sexual orientation, marital or civil partnership status, pregnancy, gender reassignment, non-job related mental or physical disability, genetic information, veteran status, military service, application for military service, or membership in any other category protected under law.

EEO is the Law - https://www.dol.gov/ofccp/regs/compliance/posters/pdf/eeopost.pdf

EEO is the Law Supplement - https://www.dol.gov/ofccp/regs/compliance/posters/pdf/OFCCP_EEO_Supplement_Final_JRF_QA_508c.pdf

Pay Transparency Policy - https://www.dol.gov/ofccp/pdf/pay-transp_formattedESQA508c.pdf

Reasonable Accommodations

Shire, a wholly-owned subsidiary of Takeda, is committed to working with and providing reasonable accommodation to individuals with disabilities. If, because of a medical condition or disability, you need a reasonable accommodation for any part of the application process, or in order to perform the essential functions of a position, please call 484-595-8400 and let us know the nature of your request and your contact information.


Please visit our website at takedajobs.com

 
 


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