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Posted: 10/19/2026Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in Case Management, including patient access coordination, insurance authorization processes, and reimbursement issue resolution. Proficient in communication and customer service, with a strong understanding of pharmaceutical industry practices and regulatory compliance.
Highest-signal resume keywords
Case Management ExperiencePharmaceutical Industry KnowledgeInsurance Authorization ProcessesCommunication SkillsReimbursement Issue Resolution
About the role
Key responsibilities & impact- Provide day-to-day oversight of patient customer service issues involving insurance, specialty pharmacies, and patient support programs
- Interact daily with Regional Business Managers, Patient Access Liaisons, and Medical Science Liaisons regarding insurance approvals and reauthorizations
- Case manage all steps required to gain patient access to therapy with RBMs, PALs, the hub, pharmacy, and patients/families
- Partner with Safety and Pharmacovigilance to report adverse events and product complaints through medical information
- Maintain case histories and relevant notes for all U.S. patients
- Maintain and update patient status to track reimbursement and shipping
- Triage, troubleshoot, and resolve reimbursement issues including prior authorizations, denials, appeals, reauthorizations, overrides, and billing problems
- Liaise with medical offices to obtain insurance authorizations
- Counsel patients and families on insurance and reimbursement options
- Identify adherence trends and suggest appropriate action
- Report weekly changes in patient status, adjudication status, reimbursement trends, successes, and roadblocks
- Manage, track, and report on annual Open Enrollment efforts
- Advise patients and families on insurance, financial assistance, and therapeutic access programs
- Attend patient meetings, industry conferences, and sales meetings
Requirements
What you’ll need- Master’s degree OR bachelor’s degree and 2 years of Case Management experience OR associate’s degree and 6 years of Case Management experience OR high school diploma/GED and 8 years of Case Management experience
- Bachelor’s degree strongly preferred
- 5+ years of experience in the pharmaceutical industry
- 2+ years prior experience as a Case Manager
- Excellent communication skills and commitment to customer service
- Ability to effectively resolve hurdles across multiple cases at the same time
- Ability to learn product and disease information
- Familiarity with HIPAA and FDA
- Ability to manage communication with case managers and sales reps across multiple geographies and time zones
- Excel and PowerPoint skills required
- Up to 20% travel required
Benefits
Comp & perks- Comprehensive employee benefits package
- Retirement and Savings Plan with generous company contributions
- Group medical, dental and vision coverage
- Life and disability insurance
- Flexible spending accounts
- Discretionary annual bonus program or sales-based incentive plan for field sales representatives
- Stock-based long-term incentives
- Award-winning time-off plans
- Bi-annual company-wide shutdowns
- Flexible work models, including remote work arrangements, where possible
- Career development opportunities
- Up to 20% travel
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Case ManagementPatient Access CoordinationInsurance AuthorizationReimbursement ResolutionAdverse Event ReportingData TrackingTrend AnalysisProblem SolvingProduct KnowledgeHIPAA Familiarity
Soft Skills
Excellent CommunicationCustomer Service CommitmentMulti-Tasking AbilityCounseling SkillsCollaboration
Tools & Technologies
ExcelPowerPoint
Industry Keywords
PharmaceuticalPatient Support ProgramsMedical Science LiaisonRegional Business ManagerPharmacovigilanceOpen EnrollmentFinancial Assistance ProgramsTherapeutic Access