*summary*:
the case manager (patient navigator) provides specialty brand education and case management support for healthcare providers and patients. From intake to outcome, nps case managers are dedicat-ed to supporting healthcare providers and patients throughout the journey by providing ongoing edu-cation, support, solutions, and dedicated resources to help limit barriers that may hinder appropriate patient outcomes.
Under the general supervision of the nps supervisor, the case manager is responsible for customer service, support, education, outreach, and case management for patients. As a case manager, you will be assigned a specific territory to work within and become an expert in that regional area to best assist the individuals who call in, enroll, or require financial assistance.
The case manager will work interactively with internal teams, patients, healthcare providers, pharma-cies, and other external parties. The case manager team will also support various patient education and financial assistance functions. The case manager will respond to all patient and customer/provider account inquiries.
This position does not involve the practice of nursing, provide clinical advice or counseling for the pa-tient. Documents all interactions with the novartis patient support center are in compliance with hipaa regulations.
*about the role*:
*your responsibilities will include, but are not limited to*:
- the case manager interacts directly with health care providers, office contacts, patients and/or their caregivers via telephonic support and acts as a single point of contact and voice for patients.
- professionally and compliantly interact with customers, relevant novartis associates, and other external contacts during inbound and outbound phone calls.
- manage assigned cases throughout the patient journey; perform proper and timely escalation, tracking, triage and follow-up where required
- handle complex interactions and/or cases as it pertains to navigating insurance, specialty pharmacies and financial assistance with exceptional customer service
- educates on support resources and information relating to novartis therapies as prescribed by an hcp, including access offerings, disease state and relevant dosing/administration, treatment reminders within the established guidelines of approved call cadence guides and work instructions
- adhere to call guides, job aides and work instructions for case processing and case cadence.
- adhere to service level agreements (slas), key performance indicators (kpis), productivity, and quality metrics.
- leverage dual monitors and technological solutions to support case management activities.
- accurately and concisely document all interactions to inform cross-functional partners on the relevant status details.
- promptly and courteously respond to tasks and notifications from psc counterparts.
- works on problems of moderate scope where analysis of data requires a review of a variety of factors. Exercises judgment within defined standard operating procedures to determine appropriate action
- ability to work independently or as a team member, typically with mínimal instruction on day-to-day work, general instructions on new assignments
- extensive knowledge of hipaa regulations and follows all company policies
- provides education and support for risk evaluation and mitigation strategy (rems) program requirements.
- as applicable, raise innovative ideas which will drive improved efficiency and effectiveness of customer service to supervisors.
- responsible for identifying and reporting adverse events via the established novartis systems as per applicable processes.
*what you’ll bring to the role*:
- education:
- bachelors degree required
- travel requirements:
- proximity and ability to commute to work onsite in mexico city 3 days per week, as required by our hybrid model and for occasional meetings or events. To be scheduled at the discretion of the business. Onsite expectations one week per month and occasional meetings or training as needed.
- other work requirements:
- when working from home, a quiet dedicated space with internet/wifi service or the ability to obtain such service where the employee can work without interruption
- ability to work the scheduled work hours, which generally will be a 9-hour shift with two paid rest breaks and an unpaid lunch break; working schedule is either 8:00 am est - 5:00 pm est/9:30 am - 6:00 pm est or 11:00 am est - 8:00 pm est
- must allow for some flexibility on scheduled hours, including weekday and/or weekend overtime if required
for patient support center (psc) roles with a dedicated training period: the individual hired for this role will be required to successfully complete initial training, including passing simulations and become certified to do the role.
*required experience*:
- previous 5+ years of experience in a specialty pharmacy, medical insurance, reimbursement hub experience, physician’s offi