Senior Case Manager

Job Summary

To support a growing pharmaceutical support practice, the remote Senior Case Manager will manage day-to-day case oversight, coordinate patient reimbursement processes, and serve as a primary resource for patients and healthcare providers in navigating complex reimbursement cases.

Key responsibilities

• Provide oversight and coordination of caseload to ensure timely completion of case elements and tasks
• Act as the primary contact for prior authorization and appeal processing communications with patients and healthcare providers
• Serve as a patient advocate, coordinating access services and troubleshooting complex cases while ensuring adherence to quality standards

Required qualifications

• Bachelor's degree or six years of relevant working experience
• Five or more years of experience in pharmacy benefit management, specialty pharmacy, or patient support/access services preferred
• Three or more years of experience in pharmacy and/or medical benefit verifications, prior authorization, and/or appeals required
• Experience as a Medical Assistant, Social Worker, or Senior Reimbursement Specialist preferred
• Proficiency in Microsoft Office applications and knowledge of medical and claims processing terminology