Remote Denial Management Jobs in Indiana (NOW HIRING)

This is a fully remote role based in the United States. Ideal candidate will reside within the time zone of the support territory, though all qualified candidates will be considered. The hours for this role would be

8:30AM-5PM EST. Role may require up to 10% travel to existing Alexion sites. Travel needs may be higher during new hire trainings and refresher trainings.

This is what you will do:
The OneSource Support Specialist is a high-touch Patient Support Program (PSP) role within the Patient Services Department centered on delivering exceptional and personalized support to patients within the Alexion Rare Disease patient journey. Working as part of a Regional Care Team, the OneSource Support Specialist serves as the primary point of contact to patients and caregivers throughout their treatment journey from initial onboarding of product through long-term customized treatment adherence support. OneSource Support Specialist provide disease state education, treatment support through community connections, and access support for patients with rare and ultra-rare diseases. OneSource Support Specialist ensure patient treatment compliance and provide resolutions to non-clinical treatment issues for patients through communication and collaboration with both internal cross-functional partners and external stakeholders.

You will be responsible for:
Providing exceptional initial onboarding experience and long term adherence support
Share materials on the disease, diagnosis, community resources and treatment support
Maintain and communicate up-to-date knowledge of the resources available as needed, including approved external resources
Place the required welcome calls to patients to introduce the OneSource program and confirm required/requested support
Communicate Benefit Investigation (BI) results with patients and HCP and help interpret them, as needed
Inform patient of financial support eligibility based on available programs
Enroll patient in Alexion financial assistance programs as eligible or refer to external support programs as appropriate
Proactively conduct routine and/or year-end reverification of coverage outreach by working with patients and caregivers, healthcare providers, insurance companies, and Alexion colleagues
Connect patients to the Alexion patient community and inform them about available advocacy groups for their disease
Assist patients in receiving required vaccinations either through Alexion or other vaccination locations
Efficiently navigate CRM documentation and other required record keeping during all patient interactions as to maintain high visibility into patient case status
Properly and immediately report Adverse Events during any customer interactions in the PV Event Reporting Tool
Act as the primary coordinator of all HCP needs across onboarding from case creation to product delivery and ongoing support through lifetime of product use
Coordinate with other appropriate HCP facing roles and cross functional partners to respond to questions from physicians and office staff and address any issues
Communicate with HCPs to confirm required/requested support or obtain missing information
Proactively and effectively consult with and engage the appropriate internal cross functional partners to resolve barriers quickly
Maintain working understanding of the reimbursement process, and leverage knowledge to communicate with internal and external stakeholders while insurance approval is being obtained and work with appropriate field specialists for denial/appeal support
Trigger initiation of adherence program on conclusion of onboarding and connect with patients through defined channels for the determined touchpoints based on product-specific programs
Educate prescribed patients and their caregivers regarding how to prepare for and what to expect during the long-term adherence of the Alexion product or switching from one Alexion product to another
Provide emotional support for patients and caregivers on continued administration of Alexion products

Will also be crucial to:
Develop compliant and collaborative professional relationships with all relevant internal and external customers including but not limited to Patient Education Managers, Field Reimbursement Managers, Regional Account Managers, Customer Operations Representatives, Medical Accounts, Access Specialists, Specialty Pharmacies, Site of Care staff, and office coordinators
Effectively escalate access issues by informing the right stakeholders of actions to be taken to resolve any pending items in a timely manner
Collaboratively work with and share responsibilities with other Alexion members and external partners members for pull through of the target patient and HCP experience
Participate in any role appropriate cross functional collaboration work (e.g.Hypercare calls, regional cross functional meetings, One Alexion meetings)
Participate in other project work as needed

You will need to have:
Associates Degree is required
Minimum of 3 to 5 years Case Management OR recognized equivalent of education and experience (e.g. contact center, nursing, social service support, healthcare customer service, insurance reimbursement, patient advocacy, etc.)
Well-developed, effective communication, collaboration and problem-solving skills, as well as data entry/computer literacy skills
Ability to work independently, be goal-directed and have strong organizational skills
Must be flexible as well as easily adapt to a changing work environment which will require ongoing maintenance/training of job-related skills/activities
Must be willing to adjust work schedules in response to department needs.
The duties of this role are generally conducted in an office environment. As is typical of an office-based role, employees must be able, with or without an accommodation to: use a computer; engage in communications via phone, email, video, and electronic messaging; engage in problem solving and non-linear thought, analysis, and dialogue; collaborate with others; maintain general availability during standard business hours.
We would prefer for you to have:
BA/BS Degree is preferred; patient contact center or patient support program experience is a plus
Excellence at communicating over the phone and handling phone systems and/or experience in a call recorded environment
Familiarity with the relevant legal and regulatory components of the pharmaceutical and biotech industry
Rare disease experience a plus
Deep understanding of insurance coverage and reimbursement processes
Familiarity with managed care and particularly "buy and bill" therapy as well as with reimbursement for infused therapies
Experience dedicated to assisting patients/caregivers
Demonstrated success working within high performing cross-functional teams
Strong empathetic, communication and listening skills
Ability to act with urgency, flexibility, and creativity to quickly get patients on therapy
Strong organizational skills and ability to adapt to change and react constructively in a high-energy and fast paced environment
Demonstrates initiative, teamwork, and accountability

The annual base salary for this position ranges from $86,663 -$129,950. However, base pay offered may vary depending on multiple individualized factors, including market location, job-related knowledge, skills, and experience. In addition, our positions offer a short-term incentive bonus opportunity; eligibility to participate in our equity-based long-term incentive program (salaried roles) or to receive a retirement contribution (hourly roles).

Date Posted

Closing Date

Our mission is to build an inclusive environment where equal employment opportunities are available to all applicants and employees. In furtherance of that mission, we welcome and consider applications from all qualified candidates, regardless of their protected characteristics. If you have a disability or special need that requires accommodation, please complete the corresponding section in the application form.