Patient Services Case Manager - Field/Remote

Company: Glaukos Industry: Medical Technology and Pharmaceutical Level: Full time Location: Aliso Viejo, CA Compensation: Base Salary Range: $54,200 - $78,500 OVERVIEW Position Summary The Case Manager (CM) is an important part of the Glaukos Patient Services (GPS) team and facilitates the Patient Journey by working directly with managed care organizations to facilitate appropriate services to ensure patients have access to Glaukos’ sight saving technologies. The CM will provide day-to-day oversight and coordination of caseload to ensure all activities are completed timely and ensure cases move through the process as required. Compensation Compensation for each successful candidate will be based on several factors, which may include qualifications, experience, education, talent availability, and local market conditions. Range listed is not inclusive of additional compensation such as bonus, equity, or additional benefits › RESPONSIBILITIES Collaboration Collaborates with Reimbursement Liaisons and Patient Support Specialists to identify and eliminate barriers to access for patients enrolled in GPS. Troubleshoot Troubleshoot complex cases while interfacing with key stakeholders, internal and external, to ensure optimal access to treatment for patients. Duties Assess benefit plans for coverage and limitations and documents necessary information for provider education. Maintain and manage a caseload of enrolled patients according to GPS guidelines and deadlines; ability to prioritize tasks when complex issues arise. Act as a single point of contact responsible for performing preliminary benefits investigations, prior authorization and appeal support as required by each case. Communication Manages all forms of communication in a timely and professional fashion to ensure patient needs are fully met and all relevant internal stakeholders are appropriately updated. Leadership Demonstrates positive leadership, without authority, to peers, upper management and other stakeholders by leveraging skills and expertise in patient support management. Travel Ability to travel, as well as overnight travel (~20%) and attendance at scheduled training and meetings. REQUIREMENTS Experience Significant experience working with a Patient Service Center/Hub and 3+ years experience working in Patient Services and/or patient access programs, 3 + years case management, patient advocacy or patient access manager experience. 2 + years Eyecare, Rare Disease, Buy and Bill, or Specialty Pharmacy experience preferred. Qualifications Medical Billing & Coding Certification a plus. Payer/insurance coverage experience with Medicare, Medicare Advantage, VA/Tri-Care, Commercial and Medicaid plans. Proven record of accomplishment in achieving objectives and corporate goals with minimal direct supervision while having excellent time management and prioritization skills. Education Bachelor’s Degree OR 8-10 years patient services/case management experience. Skills Strong computer and technical skills and the ability to navigate software programs to process and analyze specific data with excellent verbal and communication skills. Experience Significant experience working with a Patient Service Center/Hub and 3+ years experience working in Patient Services and/or patient access programs, 3 + years case management, patient advocacy or patient access manager experience. 2 + years Eyecare, Rare Disease, Buy and Bill, or Specialty Pharmacy experience preferred. Qualifications Medical Billing & Coding Certification a plus. Payer/insurance coverage experience with Medicare, Medicare Advantage, VA/Tri-Care, Commercial and Medicaid plans. Proven record of accomplishment in achieving objectives and corporate goals with minimal direct supervision while having excellent time management and prioritization skills. Education Bachelor’s Degree OR 8-10 years patient services/case management experience. Skills Strong computer and technical skills and the ability to navigate software programs to process and analyze specific data with excellent verbal and communication skills. ‹ › ABOUT US Founded in 1998, Glaukos Corporation is an ophthalmic medical technology and pharmaceutical company focused on novel therapies for the treatment of glaucoma, corneal disorders, and retinal diseases. Our company was the first company to bring to market Micro-Invasive Glaucoma Surgery (MIGS), the micro-invasive procedure which revolutionized the treatment and management of glaucoma. In 2012, we launched our first MIGS device—the iStent®—in the United States, followed by our next-generation iStent inject® device in September 2018 and iStent inject® W in September 2020. In November 2019, Glaukos acquired Avedro, maker of the first and only FDA-approved cross-linking technology for progressive keratoconus. And we continue to seek to leverage our platform technologies to build a comprehensive and proprietary portfolio of micro-scale surgical and pharmaceutical therapies for glaucoma, corneal health, and retinal diseases.