Case Manager

About the Role

Inizio Engage is partnered with a top Biotechnology firm, covering Commercial, Patient Solutions, and Medical Affairs sectors. This role is crucial in aiding patient access and reimbursement workflows, serving as a primary link among patients, healthcare providers, insurance payers, and internal HUB teams. The ideal candidate is detail-oriented with strong case management skills and a compassionate focus on patient care.

Responsibilities

• Oversee patient cases from referral through therapy initiation, ensuring accurate, compliant, and timely management.
• Perform benefits investigations via electronic systems or contacting insurers to clarify coverage, prior authorization, and financial obligations.
• Execute and monitor prior authorization and appeals activities by gathering plan criteria, submitting requests, and following up with relevant parties for timely resolution.
• Assist patient enrollment in financial support programs including copay and assistance initiatives.
• Facilitate communication with patients, healthcare professionals, payers, and specialty pharmacies.
• Educate stakeholders on insurance coverage, access pathways, and treatment next steps.
• Collaborate with internal and external teams to guarantee prompt therapy starts and compliance with service standards.
• Accurately document case information in HUB systems adhering to policies, SOPs, and regulations.
• Monitor case progression and escalate complex reimbursement challenges as required.
• Handle incoming calls from patients, caregivers, and prescribers, managing or redirecting as necessary.
• Support leadership by tracking and resolving escalated cases.
• Contribute to quality assurance, audits, and continuous improvement initiatives.
• Maintain strict compliance with HIPAA, privacy, and regulatory requirements at all times.

Requirements

• Bachelor’s degree or equivalent experience is preferred.
• Prior involvement in patient access, HUB services, reimbursement support, specialty pharmacy, or healthcare case management is advantageous.
• Knowledgeable in benefits investigation, prior authorization, appeals, and patient financial assistance processes.
• Excellent communication skills coupled with a patient-centered attitude.
• Capability to handle high volumes of cases efficiently within a fast-paced environment and meet service expectations.
• Familiarity with CRM platforms and Microsoft Office suite.
• Strong organizational, analytical, and problem-solving competencies.
• Effective workload prioritization and multitasking abilities.

Compensation and Benefits

• Annual base salary ranges between $38,000 and $70,000, determined by experience, skills, equity, and company needs.
• Comprehensive benefits package including medical, dental, vision, paid time off, 401(k) with match, disability, life insurance, and paid parental leave.
• Company-paid holidays; recognition programs, contests, and awards; and opportunities for continuous learning and career advancement.
• A collaborative work environment that values your contributions and ideas.

Additional Information

Inizio Engage values equality and inclusivity, offering equal opportunity employment and reasonable accommodations as per legal requirements. The company complies with fair chance hiring laws and may condition employment on successful background checks, ensuring considerations align with role requirements.

The use of Artificial Intelligence tools during interviews is prohibited unless explicitly authorized or legally necessary to ensure fairness and equity. Candidates may be required to confirm adherence to this policy.

About Inizio Engage

Inizio Engage specializes in strategic, commercial, and creative healthcare engagement solutions using data, science, and technology to improve patient, payer, provider, and professional interactions, aiming for better treatment outcomes. The company culture emphasizes empowerment, collaboration, integrity, and continual improvement.