14 days old

Case Manager

Alnylam Pharmaceuticals
Cambridge, MA 02139
  • Job Code
    200034

Case Manager

Overview

Alnylam is the world's leading RNA interference (RNAi) company.

Founded in 2002, Alnylam was built upon a bold vision of turning scientific possibility into reality by harnessing the power of RNAi for human health as an innovative new class of medicines. We are a growing biopharmaceutical company with three approved medicines and a robust pipeline of investigational medicines focused in four strategic therapeutic areas: genetic medicines, cardio-metabolic diseases, infectious diseases, and central nervous system (CNS) and ocular diseases, including several in late-stage development.

Headquartered in Cambridge, Mass., Alnylam employs over 1,500 people in 19 countries and is rapidly growing globally, with additional offices in Norton, Mass., Maidenhead, U.K., Zug, Switzerland, Amsterdam, Netherlands, and Tokyo, Japan. Alnylam is proud to have been recognized as one of The Boston Globe's Top Places to Work six years in a row (2015-2020), a Great Place to Work in the U.K. and Switzerland two years in a row (2019-2020) and a Science Magazine's Top Employer two years in a row (2019-2020). Please visit www.alnylam.com for more information.

We are currently building out our US Patient Services team to provide exceptional customer service on all levels. The Case Manager (CM) will be a critical component of the commercial strategy and work in close coordination with Field Sales, Field Reimbursement, Patient Education Liaisons and Patient Advocacy Teams to support Alnylam's patient-focused vision of harnessing a revolution in biology for human health . Reporting to a Regional Manager, U.S. Patient Services seeks experienced, passionate, patient-focused individuals committed to improving the lives of those living with hereditary transthyretin-mediated amyloidosis (hATTR amyloidosis), acute hepatic porphyrias (AHP) and primary hyperoxaluria (PH).

The CM will be responsible for interfacing with patients affected by these rare diseases, their caregivers, and healthcare providers (HCPs), to facilitate unencumbered access to treatment. The CM will work collaboratively with internal and external stakeholders to meet individual patients' needs through personalized, compassionate communication and high-touch services. He/she is responsible for engaging multiple stakeholders in support of getting appropriate hATTR amyloidosis/AHP/PH individuals started on therapy and staying on therapy. The CM focuses on identifying and coordinating various services that individual patients may need to get access to therapy and recognizing and removing reimbursement barriers that prevent the individual from remaining on therapy.

The successful candidate must exhibit a positive attitude and be passionate about science and deeply motivated by the quest of delivering value to patients and their families with the long-term success of the company in mind. He/she will be responsible for providing a smooth customer interaction from initial intake through supporting continued patient access to therapy. He/she will manage the logistical issues impacting treatment initiation and ongoing therapy. The CM demonstrates understanding of the department business objectives and measures and demonstrates strengths working independently as well as collaboratively within a highly matrixed environment.

Summary of Key Responsibilities

  • Assesses patients' needs and develops action plans that provide for the initiation and continuation of treatment with Alnylam products while coordinating the exchange of all applicable patient-related information with appropriate internal and external customers.
  • Develops a comprehensive understanding of the reimbursement process, billing/coding nuances, insurance plans, payer trends, financial assistance programs, patient assistance programs, and related resources.
  • Support Operational Excellence across the team by reinforcing need for accurate, complete and timely case documentation, data integrity, and process improvement opportunities.
  • Assists in obtaining insurance approval for Alnylam products, and proactively plans for maintenance of coverage by working with patients and their caregivers/families, healthcare providers, insurance companies, specialty pharmacies, and Alnylam colleagues.
  • Understands the resources available in their specific region, and how they can be best employed to support patient care.
  • Identifies complex patient-specific issues and develops and executes action plans accordingly.
  • Maintains disease, reimbursement and insurance coverage expertise through continuing medical education and attendance at relevant conferences and other educational opportunities.
  • Effectively shares reimbursement and other knowledge with cross-functional team members through case studies and complex case consultations.
  • Demonstrates the ability to consistently trouble-shoot, develop, and implement solution-focused problem-solving surrounding complex product access and reimbursement issues.
  • Champion cross functional, Alnylam Assist team support on all initiatives designed to provide holistic improvements to case management process, escalated issues, product launches, benefit re-verification, training. Includes other projects designed to roll out new, highly visible business objectives.
  • Support team members to meet patient needs and department goals
  • Leverage cross functional relationships to optimize patient experience
  • Educates patients, caregivers, family members, health care providers, and others regarding insurance options and limitations, including requirements necessary to initiate and maintain treatment, patient services' offerings and relevant disease/product information as necessary.
  • Fosters strong relationships with internal and external stakeholders, exhibited through sound judgement, professional demeanor, and timely follow-through.
  • Maintains accurate data on each individual, their insurance, coverage approvals, on-going coverage requirements and all patient and provider interactions.
  • Consistently monitors systems and processes; recognizes trends and the need to adopt new approaches
  • Consistently contributes in cross-functional settings to offer patient services perspective
  • Shares case management and reimbursement best practices with cross-functional and internal teams to enhance collective knowledge and maximize team efficiencies
  • Attend patient meetings and represent Alnylam at industry conferences, as needed
  • Ensures compliance with all corporate and industry policies in collaboration with Alnylam Legal, Regulatory and Compliance.

Additional Information: Flexibility

  • This position allows for the flexibility to work from home up to 3 days per week which may happen after 6 months on the job.
  • We understand the need to balance business needs with personal flexibility needs; our goal will be to accommodate personal flexibility needs, however, there will be times when attendance in the office is required for certain meetings and we will be forthcoming with those details as we go.
  • During COVID-19 pandemic, this role is WFH and will be evaluated in accordance with state, local or Alnylam policies, if applicable

Qualifications

  • Bachelor's Degree required. Health Care/Social Work/Nursing (or related field) a plus.
  • 3 years recent case management experience in the healthcare or pharmaceutical/biotech industry. Ultra-rare disease experience a plus.
  • Experience should include but not be limited to home care management, case management review, utilization review, social service support, insurance reimbursement, patient assistance programs, or billing and coding.
  • Knowledge of benefit verification and prior authorization process for infused and injectable products.
  • Knowledge of private payer, Medicare, and Medicaid structure, systems, and reimbursement process required.
  • Experience and proficiency in working with a Customer Relationship Management System, such as Salesforce.com.
  • Possess strong written and verbal communication skills, exceptional listening, critical thinking, problem solving, negotiation and mediation skills.
  • Ability to navigate difficult conversations and handle sensitive issues with opposing opinions.
  • Ability to work independently and manage competing priorities, and address an audience on a specialized topic
  • Desire to innovate and work in a fast-paced, flexible, and energetic environment.
  • Self-starter who is highly passionate about rare disease and Alnylam's core values:
    • Commitment to People, Innovation and Discovery, Sense of Urgency, Open Culture, and Passion for Excellence.
  • Ability to travel 5%, including weekends/evenings, as needed.

Alnylam Pharmaceuticals is an EEO employer committed to an exciting, diverse, and enriching work environment. #LI-BS1





Posted: 2021-01-06 Expires: 2021-02-04
Sponsored by:
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Case Manager

Alnylam Pharmaceuticals
Cambridge, MA 02139

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