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We are looking for aRare Disease Case Managerfor the West Coast Region who isadaptable, highly collaborative and solution orientedto join us in our Patient Support Program.This position can be remote/virtual, based in the US supporting the Pacific time zones.The standard hours of operations for this role are 8:30am to 5:00pm PST dependent upon place of residence. This remote role requires twenty percent face-to-face interactions and can be based on the following metropolitan areas and subject to change:Pacific Northwest, Southwest, Great Plains. Must live in the Pacific time zone.

About the role

The Rare DiseaseCase Managerserves asa subjectmatter expert on access & reimbursementwho hasextensive expertise in navigating insurance and access-related barriers.This role is designed to help patients gain access to prescribed UCB rare disease products and patient support, serving as the escalation point for difficult access related patient cases. This individual will share insights and collaboratively coordinate services with internal and external program partners.This role requires significant knowledge in the market access and reimbursement landscape encompassing procurement, payer policies and coverage, benefit design, prior authorizations, appeals, exceptions, denials, coding and payer payment guidelines, site of care differences and nuances.

Who you'll work with

• Case Managers
• Rare Reimbursement Executives
• Care Coordinators
• Cross functional partners including specialty pharmacies, HUB partners, payers, and as needed, physicians, office coordinators, nurses and pharmacists

What you'll do

• Serve as expert on challenging market access patient cases specific to benefit verifications, product procurement processes, reimbursement information, billing, coding, and coverage details, after clinical decisions have been made by the prescriber.

• Coordinate the benefit verification referral process with UCB's service center(s) and deliver timely and accurate follow up to account stakeholders to help ensure patient access to UCB medicines.
• Provide appropriate Appeal & Claims Denial Support

• Understand, provide quality control, communicate patient specific insurance coverage along with access and affordability options to team to support patients
• Establish self as national and regional expert on payer trends, product access, and reporting reimbursement trends and/or delays (i.e., denials, underpayment, access delays, etc.)
• Coordinate and collaborate with UCB Rare Reimbursement Executives, Care Coordinators, specialty pharmacies, needed HCP (Health Care Professional) offices, infusion providers, other key personnel on complex cases which require strategic intervention
• Manage and facilitate specialty pharmacy relationships, responsible for dispersing updates to team members and ensuring forward patient momentum
• Ensure understanding of the buy and bill reimbursement process, specialty pharmacies practices, field reimbursement support activities, and patient support programs

Interested? For this role we're looking for the following education, experience and skills

Minimum Qualifications

• Bachelor's degree
• 8-10 years of experience in pharma, biotech, or healthcare space

• 5+ years of Case manager experience supporting market access, site of care selection
• 5+ min yrs of excellent working knowledge of evolving reimbursement landscape and the practice management environment
• Ability to Travel minimum of 20%

Preferred:

• Masters Preferred, or extensive relevant experience
• Rare disease and/or infusion experience
• Nursing degree/healthcare clinical experience
• Above-average skills with technology, including ability to quickly learn and accurately utilize contact center systems, CRM, and virtual platforms
• Experience in managing access complexities associated with a new to market medication
• Experience with specialty pharmacy products / products acquired through specialty pharmacy networks or specialty distributors (buy and bill)
• Close connectivity to the everchanging payor medical benefit policy arena
• Excellent virtual interaction and communication skills - both written and verbal
• Demonstrated flexibility, adaptability, and the ability to prioritize tasks and meet customer demands

Internal applicants should be in their current job for at least 12 months, must meet performance standards and are not on formal corrective/disciplinary process (PIP), warning, final warning, or compliance warning letters within the last 12 months. Please inform your Manager or your Talent Partner before applying to any internal job opportunities.

Unlessexplicitlystated in the description, this role is hybrid with 40% of your time spent in the office,regardlessof your current contractual agreement. If your current working arrangements differ, please contact your Talent Partner to discuss before submitting your application.

UCB is an equal opportunity employer. All employment decisions will be made without regard to any characteristic protected by applicable federal, state, or local law. UCB invites you to voluntarily self-identify during the application process. Provision of self-identification information is entirely voluntary and a decision to provide or not provide such information will not have any effect on your application for employment, your employment with UCB, or otherwise subject you to any adverse treatment. Any information you provide will be considered confidential and will be kept separate from your application and/or personnel file and will only be used in accordance with applicable laws, orders, and regulations.

Should you require any adjustments to our process to assist you in demonstrating your strengths and capabilities contact us on US-Reasonable_Accommodation@ucb.com for application to US based roles. Please note should your enquiry not relate to adjustments; we will not be able to support you through this channel.

Requisition ID:93300

Recruiter:Mary Fagundo

Hiring Manager:Wendy Lewis

Talent Partner:Caroline Nolen

Job Level:MM II

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