Regional Patient Case Manager-Long Term Care
- Full-Time
**Remote Work Flexibility**
Purpose:
The Regional Patient Case Manager – Long Term Care (RPCM-LTC) is a professional client facing role responsible for various functions, including accurate and timely response to client inquiries regarding patient-specific programs, referral status or escalation, benefits verification and financial assistance counseling. The RPCM-LTC acts as a single point of contact for communication and coordination among all participants of the LTC facility health care team to ensure that the services are provided. The RPCM-LTC is responsible for providing professional, concise internal and external communication regarding case status updates, next steps in prescription processing, shipment set ups, and communication of reimbursement issues. The RPCM-LTC oversees the provision of extended, ongoing services to residents of long-term care facilities. Also, provides intensive case management in a collaborative process that includes therapy initiation, referrals to Specialty Distributors, and triages to Specialty Pharmacy or Long-Term Care Pharmacies.
Responsibilities:
Serve as the point of contact for regionally aligned field team related to cases identified as LTC to initiate and support therapy to residents of long-term care facilities.
Coordinate all LTC facility-related support and access services across all functions including patient support and welcome, benefits verification and triage to specialty pharmacy.
Review and add LTC profile data to capture the key information related to LTC facilities and customers.
Conduct initial welcome calls to LTC facility-designated champions and/or patients/caregivers informing them of available services as well as future targeted outreach to provide ongoing support.
Maintain frequent touchpoints through outreach to LTC providers and patients/caregivers to communicate progress throughout their journey.
Work independently to complete assigned work in accordance with Standard Operating Procedures and defined service levels to complete program enrollment, answer inquiries, and coordinate access to free 14-Day Supply Program, if applicable.
Independently and effectively identify adverse events and/or product complaints and triage as appropriate.
Apply defined business rules to qualify patients for manufacturer supported programs.
Interact and coordinate with internal program operations, including reimbursement, and program management to ensure provider and patient needs are met in addition to attending any regularly scheduled calls.
Provide support, education and status updates to regionally aligned field teams, LTC facility staff, patients and caregivers to ensure efficient referral processing, triaging, and shipment set ups.
Manage assigned territory using problem solving skills and professional judgement to independently make sound decisions for timely case resolution.
Ability to coordinate and collaborate with manufacturer representatives, LTC facilities and other key personnel on complex cases which require strategic intervention.
Independently and effectively resolves complex issues with creativity and innovation while maintaining compliance.
Refer patients to third-party or other foundation programs per program business rules.
Manage case triage to Specialty Pharmacy or Long Term Care Pharmacy, if applicable, and ensure proper information has been communicated to the Specialty Pharmacy Liaison.
Collaborate with SPs and field teams on case recovery efforts.
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