Hub Case Manager

Overview:

Our client, a Global Fortune 50 organization and one of the world’s largest distributors of healthcare systems, medical supplies & pharmaceutical products, seeks an accomplished Hub Case Manager.

*** Candidate must be authorized to work in USA without requiring sponsorship ***

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Location: Cary, NC 27513

Duration: 3 - 4 months contract w/ possibility of extension or conversion to FTE role

Notes:

• Pay Rate: $24.00/hr on W2.
• Work Schedule: Mon - Fri; shift hours (8:00am – 8:00pm), 8:00am – 5:00pm shift, 10:00am – 7:00pm shift, 11:00am – 8:00pm shift.
• Must be able to work on site for the duration of program launch.

Job Description:

• The Case Manager is responsible for working closely with healthcare providers, patients, and drug manufacturer's programs managing complex reimbursement issues.
• Obtains payer specific prior authorization procedures and documentation requirements if applicable and facilitate the prior authorization process for patients and healthcare providers.
• Work with healthcare providers and patients to assist with appeal management for claim denials.
• Work with physicians and payers to advocate for product specific coverage.
• Prioritize customer questions and answer within inbound calls within SLAs.
• Will be processing high volume of cases to include benefit verifications and insurance reverifications.
• Ability to communicate product benefits and efficacy to positively influence payer policy.
• Capability to monitor drug coverage policies for multiple payers.
• Review case outcomes to analyze and identify payment and denial trends as well as key findings for client reporting.
• Ability to effectively respond to escalated issues and complex cases referred from other Reimbursement employees or manufacturer representatives.
• Conduct external research to identify appropriate alternate funding sources for inclusion to the internal resource database for future reference purposes.

Qualifications:

• High School Diploma or Equivalent.
• 5 years’ experience in the healthcare industry including, but not limited to, Medicare and/or Medicaid program administration, insurance verification and/or claim adjudication, physician’s office or outpatient billing, pharmacy and/or pharmaceutical manufacturers.
• 2 years’ customer service experience and 2 years’ medical or insurance industry experience.
• Must have an in-depth understanding of insurance plans and benefit structures to obtain detailed benefit information and maximize plan benefits.
• Needs to have an in-depth understanding of Medicare and Medicaid programs to effectively utilize internal resources and to conduct external research to identify alternate funding sources as appropriate.
• Must be able to analyze reimbursement specific data and prepare written reports for management and client communications.
• Excellent communication and organizational skills.
• Strong problem solving and decision-making skills and ability to effectively handle multiple priorities.
• Ideal candidate will need to work independently with minimum supervision.
• Detail oriented.
• Should be comfortable working independently with minimal guidance from management).

Questionnaire requested by manager (applicants must answer below with resume):

• Do you have experience or background in specialty pharmacy and HUB operations.
• Do you have reliable transportation to be onsite 5 days a week?
• What case management or customer service experience do you have?

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I'd love to talk to you if you think this position is right up your alley, and assure a prompt communication, whichever direction. If you're looking for rewarding employment and a company that puts its employees first, we'd like to work with you.

Satwinder “Sat” Singh

Lead Technical Recruiter

Company Overview:

Amerit Consulting is an extremely fast-growing staffing and consulting firm. Amerit Consulting was founded in 2002 to provide consulting, temporary staffing, direct hire, and payrolling services to Fortune 500 companies nationally; as well as small to mid-sized organizations on a local & regional level. Currently, Amerit has over 2,000 employees in 47 states. We develop and implement solutions that help our clients operate more efficiently, deliver greater customer satisfaction, and see a positive impact on their bottom line. We create value by bringing together the right people to achieve results. Our clients and employees say they choose to work with Amerit because of how we work with them - with service that exceeds their expectations and a personal commitment to their success. Our deep expertise in human capital management has fueled our expansion into direct hire placements, temporary staffing, contract placements, and additional staffing and consulting services that propel our clients’ businesses forward.

Amerit Consulting provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

Applicants, with criminal histories, are considered in a manner that is consistent with local, state and federal laws.