Nurse Case Manager

Overview

At Mercalis, our passion is success - success for clients, success for us. You’ll notice who comes first. We’re committed to providing solutions, through innovation and unparalleled customer support, to the pharmaceutical industry to improve access and affordability of their medicines to patients. We work tirelessly on the behalf of our clients, because when they succeed, so do we.

That’s not to say we are all work and no play. Mercalis is an open workplace with fun, energetic people united for a common purpose. In fact, we don’t even refer to each other as employees. We’re team members. We foster a culture that encourages individual personality.

The Nurse Case Manager is a blended role to 1) facilitate a successful patient journey to and while on therapy by providing care coordination, education, and psychosocial support, 2) provide medication and disease state education, and 3) provide clinical feedback to enhance the clinical portion of patient support programs

Responsibilities

· Provide education and support to patients, caregivers and health care providers regarding assigned therapeutic areas and maintain accurate record of activity per program setup

• Establish relationships, develop trust, and maintain rapport with patients, caregivers, and healthcare providers in a 100% telephonic setting
• Counsel and educate new/existing patients on the use of products, dosing and administration, use of devices, drug insurance coverage/reimbursement challenges
• Evaluate and contribute to development of program resources
• Coordinate and utilize resources to share and secure financial options for those with financial need.
• Follow program guidelines and escalate complex cases according to program policy and procedures.
• Receive and make calls to patients and/or caregivers regarding assigned disease states, products, and patient needs to include discussions regarding insurance coverage and available financial support options for the particular therapy
• Accurately maintain, constantly update, and successfully navigate patient account records in a digital CRM (Customer Relationship Management System)
• Support health care provider offices regarding questions, concerns, or challenges with prescription
• Report and document adverse events and product/safety complaints as per program SOPs
• Participate in program specific customer meetings and training sessions
• Participate in program specific orientation meetings and demonstrate clinical and program competency on written, evaluated tests
• Serve as an advocate to patients and health care providers regarding insurance coverage, medical billing, reimbursement process, and general access for complex pharmaceuticals.
• Participate in a shared on-call, after hours nurse service that spans multiple programs
• May be asked to perform related job duties that are not specifically set-forth in this job description.

Qualifications

• AD or Bachelor’s Degree in Nursing (BSN, RN) with a valid nursing license in one or more states
• Four or more years of nursing experience; prior telephonic experience a plus
• Knowledge of medical insurance terminology and reimbursement/insurance, healthcare billing, physician office, health insurance processing or related reimbursement experience a plus
• Ability to communicate clearly and effectively orally and in writing-may be asked to submit a written test sample
• Proficient with Microsoft products
• Experience and comfort with a digital CRM required
• Attention to detail and committed to following through in communication with patients and providers
• Empathetic listening skills in order to interact effectively with patients and providers
• Willingness to work in a fast-paced environment and have the ability to multi-task and pivot with ease
• Strong customer service experience and skills