Case Manager

Case Manager

This position supports specialty pharmaceutical manufacturers in eliminating barriers to care so that patients can access, afford, and stay on life-changing therapies. Our non-commercial specialty pharmacy and custom-designed facility near Dallas, Texas, support streamlined patient onboarding, qualification, and adherence. Join our mission to deliver therapies faster and more effectively by guiding patients throughout their care journey with compassion and precision.

Key responsibilities include managing the full care process with urgencyfrom benefit verification to medication deliveryensuring an exceptional patient experience. Conduct benefit investigations and collaborate with healthcare providers, specialty pharmacies, and insurers to ensure coordinated care. Assist in obtaining prior authorizations, insurance approvals, and appeal outcomes. Educate patients on their insurance coverage, out-of-pocket costs, and the appeals process. Address and resolve patient and provider concerns regarding case status. Maintain expertise in payer landscapes and remain informed on reimbursement changes across Medicare, Medicaid, Managed Care, and Commercial plans. Process patient enrollments via fax, phone, or electronically as needed. Review and verify accuracy of forms and documentation for data entry. Support the inbound call queue from patients, providers, and partnersaiming for first-call resolution.

Qualifications and skills include 24 years of experience in a patient-facing or high-touch customer service role, preferred. Previous experience in Hub Services or Patient Support Programs, preferred. High School diploma or equivalent, preferred. Knowledge of Medicare (Parts A, B, C, D), Medicaid, and Commercial payer guidelines, preferred. Strong interpersonal skillsflexible, empathetic, persistent, and trustworthy. Proficient in data entry and Microsoft Office tools. Understanding of pharmaceutical therapies, disease states, and adherence challenges, preferred. Excellent written and verbal communication and problem-solving skills.