Senior Case Manager

Job Summary

To support a growing pharmaceutical support practice, the full-time Senior Case Manager will manage a caseload focused on pharmacy reimbursement, ensuring timely completion of prior authorizations and appeals while serving as a primary resource for patients and healthcare providers in a remote environment.

Key responsibilities

• Provide day-to-day oversight and coordination of caseload to ensure timely completion of all case elements
• Act as the single point of contact for prior authorization and appeal processing communications with patients, healthcare providers, and external stakeholders
• Serve as a patient advocate, coordinating additional patient access services and performing quality checks on cases

Required qualifications

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