Case manager

Role Overview We are seeking an empathetic and detail-oriented professional to support patients in accessing their specialty medications. In this role, you will act as a dedicated liaison between patients, healthcare providers, and insurance companies to navigate coverage, secure financial assistance, and resolve complex pharmacy issues. Key Responsibilities Case Management: Steward patient cases from initial contact to final approval or denial, ensuring strict adherence to PHI compliance and operational policies. Benefits & Outreach: Conduct outbound calls to patients, specialty pharmacies, and insurance providers to verify benefits, co-pays, and coverage status. Problem Resolution: Mediate complex payer/pharmacy issues, answer patient status inquiries, and research alternative funding or foundation eligibility. Real-Time Data Entry: Accurately transcribe notes and enter detailed information into proprietary software while actively conversing with customers on the phone. Compliance: Accurately identify, document, and submit Adverse Events in accordance with regulatory guidelines. Qualifications & Skills Education & Experience: High School diploma or equivalent required. Previous healthcare, pharmaceutical, or pharmacy benefits management experience (including knowledge of Medicare/Medicaid, prior authorizations, and appeals) is highly preferred. Technical Proficiency: Ability to type a minimum of 40 WPM. experience with Microsoft Office and video conferencing tools (MS Teams, Zoom). Must be comfortable working on camera as required by leadership. Multitasking: Proven ability to navigate software and document accurate notes simultaneously while speaking with customers. Communication: Exceptional, professional communication skills with a friendly, empathetic, and patient-centric approach. Work Ethic: Highly organized, independent self-starter driven to meet high-volume daily/weekly metrics. Strict adherence to company attendance policies is required.

salary: $20.19 - $20.2 per hour
shift: First
work hours: 7 AM - 7 PM
education: High School

Responsibilities

Case Management: Steward patient cases from initial contact to final approval or denial, ensuring strict adherence to PHI compliance and operational policies.
Benefits & Outreach: Conduct outbound calls to patients, specialty pharmacies, and insurance providers to verify benefits, co-pays, and coverage status.
Problem Resolution: Mediate complex payer/pharmacy issues, answer patient status inquiries, and research alternative funding or foundation eligibility.
Real-Time Data Entry: Accurately transcribe notes and enter detailed information into proprietary software while actively conversing with customers on the phone.
Compliance: Accurately identify, document, and submit Adverse Events in accordance with regulatory guidelines.

Skills

• outbound calls
• approval/denials
• co pays, verification

Qualifications

• Years of experience: 0 years
• Experience level: Experienced

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Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact View email address on click.appcast.io.

Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).

This posting is open for thirty (30) days.

It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.