Job Information
TEKsystems Case Manager in Jeffersonville, Indiana
Direct placement opportunity!
A typical day in the life of a CASE MANAGER will include the following:
RELATIONSHIP MANAGEMENT:
Builds trusted relationships with patients, prescribers, client stakeholders through proactive communication, timely and accurate execution of deliverables and demonstrated relentless passion for helping patients
Manages all relationships in a manner that adheres to healthcare laws and regulations
COMMUNICATIONS:
Perform program welcome calls to patients
Performs post benefits investigations calls to patients and physicians explaining coverage options
Manages all client inquiries unable to be determined by client through reporting
Manages HCP inquiries, as applicable, pursuant to business rules
INBOUND CALL MANAGEMENT:
Manages inbound calls as directed by the program-approved FAQ's
Triage patients to internal or external resources as appropriate
PERSONALIZED CASE MANAGEMENT
Provides personalized case management to patients and HCP's including outbound communication to HCP's and patients to communicate benefits coverage and next steps in obtaining coverage
Leverages electronic tool to identify benefits and payer coverage; completes manual benefit investigations as needed
Identifies and communicates patients' plan benefit coverage including the need for prior auth, appeal, tier exception, and/or formulary exclusions
Uses electronic resources to obtain benefit coverage outcome and if needed ,outbound call to payers and healthcare providers to follow up on proper submission/or outcome
Additional Responsibilities:
Compassionately deliver an exceptional experience to many patients per day always remembering that every prescription or document belongs to a real person who is looking for thorough efficient management of their records.
Adjust your approach to their needs by communicating clearly, focusing on the accuracy of the details of their medical records and your mastery of the program requirements, and ensuring their prescriptions or cases are handled timely.
Reporting of Adverse Events/Product Complaint inquiries received in accordance with SOP and good manufacturer practices
Provides timely feedback to the company regarding service failures r customer concerns
Effectively uses internal technology platform to complete claims processing and keep workflows moving
Communicate with key medical practice accounts, sales representatives regarding the status of cases
Provide consultative services where issues arise on how obstacles can be overcome to get patient on paid therapy.
Bilingual is a plus (in Spanish or Chinese/Mandarin)
Must have availability to train for the first 8 weeks on an 8:30am - 5:00pm schedule
Ability to work on-site
Additional Qualifications:
Service minded individuals - focus on recognizing and meeting the needs of others (especially patients and care partners)
Trouble-shooting and problem solving individuals
Tough conversations - able to be a patient advocate for patients with high prescription costs
Ability to handle personal health information with confidentiality
Commitment to honesty and integrity
Professionalism and a strong sense of proper business and customer service etiquette
Clear verbal and written communication skills
Accountability for results
Ability to plan and prioritize tasks with close attention to detail
Positive Attitude
About TEKsystems:
We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
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