Reimbursement and Access Case Manager

Key Duties

• Act as a single point of contact and subject matter expert regarding the acquisition, fulfillment and reimbursement for Alkermes products, while providing the highest level of customer service

• Develop working relationships with internal and vendor teams, needed to provide coordinated support to healthcare providers and patients

• Provide updates and account information to key internal Alkermes stakeholders such as field sales, national accounts and field reimbursement managers

• Demonstrate proficiency and full understanding of Alkermes PAS processes and database including understanding of data elements, definition of various case statuses and outcomes, case documentation requirements and the importance of meeting program metrics

• Accurately document call details, follow up actions, and any other pertinent information in the Alkermes PAS database

• Gain familiarity with reimbursement and coverage requirements for health plans within their assigned geographic territories to assist with troubleshooting and resolution of ongoing issues

• Identify and escalate customer concerns and program trends to patient access services management team and reimbursement access specialists

• Assess patient enrollment for Alkermes financial assistance programs including copay savings and patient assistance programs

• Coordinate with Alkermes PAS NC teams to assist with patient transition from inpatient/residential sites of care to outpatient treatment

• Provide back up as needed for other case managers, and members of the patient services team

• Adhere to Alkermes standard operating procedures and compliance requirements

The Alkermes Patient Access Services (PAS) team provides support for patients wishing to access Alkermes products. Support includes reimbursement and access education, refill reminder support, coordination to financial assistance and assistance locating follow on providers for site of care transitions. The Alkermes PAS team works with patients, healthcare providers and insurance companies.

The Reimbursement and Access Case Manager (RACM) will act as the single point of contact for all customers including healthcare providers, vendor partners, insurance companies to educate and provide logistical support to access Alkermes products. They will act as the subject matter expert for all topics related to reimbursement, local and regional health plan polices, coverage requirements, pharmacy coordination and any other topics impacting product fulfillment. They will also serve as a business partner to internal Alkermes stakeholders such as sales, national accounts and field reimbursement resources. The RACM will partner with the PAS Nurse Coordinators (NC) to assist patients transitioning from inpatient to outpatient care. This position would work the 11:30-8 shift.