Mito Case Manager (MCM)

Make your mark for patients

We are looking for a Mitochondrial (Mito) Case Manager (MCM) who is empathic, collaborative and patient-focused when assisting patients with the reimbursement journey to access to join us in our Onward Patient Services team, based in the U.S. as a remote/virtual role is designed to support the entire U.S.

About the role

The Mitochondrial (Mito) Case Manager is a nonpromotional role that serves as the primary point of contact for prescribers for market access and reimbursement related questions and support in navigating insurance and access-related barriers.

They understand market access and the reimbursement journey encompassing procurement, payer policies, and coverage, benefit design, prior authorizations (PAs), appeals, exceptions, denials, coding and payer payment guidelines, understanding of coding guidelines (CPT/J-Code/ICD-10), with demonstrated knowledge of the complex payer environment as it pertains to insurance benefit structures, with strong ability to relay detailed benefits information to help patients.

This individual will share insights and collaboratively coordinate support with internal and external program partners. The MCM will have strong communication skills to relay detailed benefit information and is expected to demonstrate market expertise in communicating payer criteria/terms and practices, as these relate to UCB Products.

Who you'll work with

The work of an MCM is to help patients gain access to prescribed UCB rare disease medicines by working with:

• Onward Care Coordinators
• Mito Regional Leads (MRLs)
• Legal, compliance, Market access strategy
• Specialty Pharmacies, Payers, HCPs, Office staff

What you'll do

• Serve as expert on challenging market access patient cases specific to benefit verifications, product procurement processes, reimbursement information, billing, coding, and coverage details after the clinical prescribing decision has been made by the HCP
• Provides support to accounts specific to benefit verifications, product procurement processes, reimbursement information, billing, coding, and coverage details, after the clinical prescribing decision has been made by the HCP & keep team updated
• Provide appropriate PA, Appeals, and Claims support
• Establish yourself as a national and regional expert on payer trends, product access, and reporting reimbursement trends and/or delays (i.e., denials, underpayment, access delays, etc.)
• Coordinate and collaborate with UCB Care Coordinators, specialty pharmacies, HCPs and their office staff, infusion providers, and other key personnel on complex cases that require strategic intervention
• Manage and facilitate specialty pharmacy relationships, responsible for dispersing updates to team members and ensuring forward patient momentum
• Demonstrate a strong compliance mindset, demonstrating a clear understanding of applicable laws and regulations, including patient privacy laws
• Advise HCPs on patient-specific reimbursement issues in compliance with policies and well-defined ways of working
• Provides strategic coverage/reimbursement support and marketplace feedback to internal colleagues aligned to their geographies
• Develops state-level key access stakeholder relationships with healthcare professionals who will advocate with Medicare Part A/B, Commercial and State Payers for medical and pharmacy benefit access to UCB rare disease products for patients * Expected to demonstrate market expertise in communicating payer criteria/terms and practices, as these relate to assigned products
• Provides strategic coverage/reimbursement support and marketplace feedback to internal colleagues aligned to their geographies

Interested? For this role, we're looking for the following education, experience, and skills

• 8-10 years of experience in pharma, biotech, or healthcare space
• 5+ years of case manager experience supporting market access, biologics claims and appeals manager, hospital social work, pharma, specialty pharmacy, biotech, or relevant healthcare space
• Excellent working knowledge of the evolving reimbursement landscape and the practice management environment
• Ability to understand health care insurance including CHIP, and Medicaid
• Demonstrated knowledge of the complex regulatory environment
• Above-average skills with technology, including the ability to quickly learn and accurately utilize contact center systems, CRM, and virtual platforms

Preferred

• Bachelors/Masters Preferred, or extensive relevant experience
• Pediatric experience
• Rare Disease or Ultra Rare disease experience
• Experience in managing access complexities associated with a new-to-market medication
• Experience with specialty pharmacy products/products acquired through specialty pharmacy networks

This position's reasonably anticipated base salary range is $124,000 - $162,800 annually. The actual salary offered will consider internal equity and may also vary depending on the candidate's geographic region, job-related knowledge, skills, and experience, among other factors.

Are you ready to 'go beyond' to create value and make your mark for patients? If this sounds like you, then we would love to hear from you!

About us
UCB is a global biopharmaceutical company, focusing on neurology and immunology. We are around 8,500 people in all four corners of the globe, inspired by patients and driven by science.

Why work with us?
At UCB, we don't just complete tasks, we create value. We aren't afraid to push forward, collaborate, and innovate to make our mark for patients. We have a caring, supportive culture where everyone feels included, respected, and has equitable opportunities to do their best work. We 'go beyond' to create value for our patients, and always with a human focus, whether that's on our patients, our employees, or our planet. Working for us, you will discover a place where you can grow, and have the freedom to carve your own career path to achieve your full potential.

UCB and its subsidiaries encourage diversity and inclusion in the workplace; we are an Equal Opportunity Employer. We do not discriminate on the basis of race/color/religion/sex/national origin/veteran/disability/age/sexual orientation/gender identity.

Should you require any adjustments to our process to assist you in demonstrating your strengths and capabilities contact us on EMEA-Reasonable_Accommodation@ucb.com. Please note should your enquiry not relate to adjustments; we will not be able to support you through this channel.