Case Management Specialist, South Central (Hybrid role- MUST RESIDE NEAR CAMBRIDGE, MA)

Job Title:        Case Management Specialist

Reports To:    Sr. Director, Case Management GM Patient Services                 

Department:  Patient Support Services – Type 1 Diabetes                                      

Date:              6/14/2024

About the job

We are an innovative global healthcare company, committed to transforming the lives of people with immune challenges, rare diseases and blood disorders, cancers, and neurological disorders. From R&D to sales, our talented teams work together, revolutionizing treatment, continually improving products, understanding unmet needs, and connecting communities. We chase the miracles of science every single day, pursuing progress to make a real impact on millions of patients around the world.​

Job Purpose:

Support General Medicines Specialty patients (Type 1 diabetes) and families through care coordination and case management expertise. Develop and execute personalized care plans to address patient barriers to treatment. Maintain ongoing relationships with individuals, caregivers, and healthcare providers to proactively identify and address access barriers and coordinate, as necessary, with insurance providers, specialty pharmacies and local resources. Provide best-in-class patient services to ensure a positive patient experience and support Sanofi business priorities.

Job Responsibilities:

• Leads the case management process, while balancing the needs of individual patients to align with the business needs/objectives of Sanofi and the Rare Disease Business Unit.
• Assesses patients’ needs and develops strategic action plans that provide for the initiation and continuation of treatment.
• Helps facilitate insurance approval for Sanofi therapies.
• Educates patients, caregivers, health care providers, and others regarding insurance options or limitations, insurance requirements, case management services, and relevant disease/product information as necessary.
• Maintains comprehensive understanding of the reimbursement process, navigation of health care systems, billing/coding guidelines, insurance plans, payer trends, internal and external patient assistance programs, and related resources.
• Enroll patients who qualify into the appropriate financial assistance program as needed/required.
• Maintains up-to-date knowledge of the resources available at the regional level as well as market landscape, and applies this knowledge in way that best supports patient access to therapy.
• Compliantly coordinates the exchange of patient-related information with internal and external stakeholders.
• Exhibits initiative and leadership within the cross-functional regional team. Able to consistently identify complex patient specific issues and develop action plans accordingly. Demonstrates accountability for action plan execution, and energetically drives for success and results.
• Establishes and maintains professional and effective relationships with all internal and external customers and stakeholders, including but not limited too case management colleagues, medical, sales, market access, insurance companies, specialty pharmacies, infusion site staff and office coordinators. 
• Raises own performance expectations and goals to support entrepreneurial approach to the growth of the team and the business.
• Demonstrates and maintains a high level of business acumen, understanding of Sanofi’s business model, and the role of the case manager and patient support services team in commercializing the business and driving initiatives to meet goals.
• Demonstrates innovation by consistently monitoring systems, processes, and potential gaps, offering new ideas and solutions to elevate the support program.
• Effectively shares reimbursement and other knowledge with PSS members through orientation training, case studies, consultation for complex cases, and special projects as requested.  
• Consistently maintains and documents accurate data, including insurance, coverage approvals, on-going coverage requirements, and all patient and provider interactions.
• Proficient in use of CRM tool to document work.  Consistently leverages CRM reporting tools and data analytics to make strategic territory decisions while prioritizing patient and customer needs.
• Attends patient meetings, site visits/calls, conferences and trade shows to educate individuals regarding services and other approved case management topics. Represent Sanofi in all venues in a professional manner.
• Provide caseload coverage outside of assigned territory as needed. 
• Ensure compliance with Sanofi policies.

Qualifications:

• Bachelor’s Degree and equivalent work experience

• 3-5 years of patient-facing or high touch customer interaction experience required.

• In-depth understanding of health insurance benefits, relevant state and federal laws and insurance regulations.

• Developed communication, mediation, and problem-solving skills.

• Computer literacy skills including data entry and office-based software programs.

• Ability to identify and handle sensitive issues, working independently and collaboratively within teams. 

• Ability to travel required, up to 10%, possibly weekends

Preferred Qualifications:

• Bi-lingual; Spanish language skills preferred

• Salesforce CRM experience

• Direct experience in the case management, insurance, or healthcare systems fields

• Pharma/biotech patient services experience

Why Choose Us

• Bring the miracles of science to life alongside a supportive, future-focused team.​​

• Discover endless opportunities to grow your talent and drive your career, whether it’s through a promotion or lateral move, at home or internationally.​​

• Enjoy a thoughtful, well-crafted rewards package that recognizes your contribution and amplifies your impact.​​

• Take good care of yourself and your family, with a wide range of health and wellbeing benefits including high-quality healthcare, prevention and wellness programs and at least 14 weeks’ gender-neutral parental leave.​

Sanofi Inc. and its U.S. affiliates are Equal Opportunity and Affirmative Action employers committed to a culturally diverse workforce. All qualified applicants will receive consideration for employment without regard to race; color; creed; religion; national origin; age; ancestry; nationality; marital, domestic partnership or civil union status; sex, gender, gender identity or expression; affectional or sexual orientation; disability; veteran or military status or liability for military status; domestic violence victim status; atypical cellular or blood trait; genetic information (including the refusal to submit to genetic testing) or any other characteristic protected by law.​