[Hiring] Director of Case Management @Sanofi

Role Description

Join the team transforming care for people with immune challenges, rare diseases, cancers, and neurological conditions. In Specialty Care, you’ll help deliver breakthrough treatments that bring hope to patients with some of the highest unmet needs.

The Director of Case Management, Rezurock MyRock Assist is a strategic leadership role within Sanofi Patient Support Services (PSS), responsible for leading all case management operations supporting the Rezurock patient population through the MyRock Assist hub program. This role owns the end-to-end patient journey from enrollment through sustained therapy access, overseeing hub-level case management operations, direct patient counseling on insurance coverage and program eligibility, financial assistance coordination, and the full spectrum of access barrier resolution.

A defining feature of this role is the AFP (Alternate Funding Provider) strategy leadership responsibility. The Director serves as the General Medicines PSS organization's primary subject matter expert on AFP identification, assessment, and mitigation, owning the end-to-end strategy for preserving patient access to commercially covered therapies being subverted by AFP schemes targeting manufacturer Patient Assistance Programs.

This role has a direct patient contact component, communicating directly with patients regarding coverage investigations, insurance benefit navigation, program eligibility determinations, and AFP awareness and navigation.

This position reports directly to the Senior Director, Patient Services and Specialty Pharmacy Programs, and works cross-functionally with PSS TAs, Market Access, National Account Directors, Field Reimbursement Managers, Legal, Compliance, and brand commercial teams.

This role will be remote with up to 25% national travel.

Main Responsibilities

• AFP Strategy & Case Management Operations (55%)
  • Lead AFP identification, assessment, and mitigation efforts across the Rezurock patient population.
  • Develop and continuously refine AFP detection algorithms and hub screening methodologies.
  • Maintain and expand the comprehensive AFP/TPA database tracking employer plans, AFP vendors, tactics employed, and resolution outcomes.
  • Coordinate cross-Sanofi AFP intelligence gathering across therapeutic areas.
  • Monitor evolving AFP tactics and develop proactive countermeasures.
  • Continuously refine hub business rules, enrollment forms, agent scripts, and case management workflows.
  • Analyze AFP case data to identify trends, patterns, and emerging threats.
• Case Management Operations & Direct Patient Counseling (25%)
  • Lead and oversee all hub-level case management operations for the Rezurock MyRock Assist program.
  • Establish and maintain case management workflows, business rules, escalation protocols, and quality standards.
  • Train, develop, and coach hub case managers on insurance coverage navigation.
  • Conduct coverage investigations through direct patient contact under HIPAA authorization.
  • Provide comprehensive patient counseling on all aspects of insurance coverage and access.
  • Guide patients through the prior authorization and appeals process.
  • Manage patient onboarding into the MyRock Assist program.
• Maximizer & Accumulator Mitigation (10%)
  • Manage and optimize the maximizer mitigation strategy through copay vendor partnership.
  • Monitor maximizer program performance metrics and coordinate with copay vendor.
  • Assess accumulator program impact on patient access and copay card utilization.
  • Develop strategies to preserve copay assistance value.
• Program Strategy & Stakeholder Coordination (10%)
  • Own comprehensive copay program strategy and optimization for Rezurock MyRock Assist.
  • Oversee coordination of PAP, Bridge, Quick Start, and IAP programs.
  • Monitor program utilization trends and recommend strategic adjustments.
  • Manage stakeholder relationships with Market Access and National Account Directors.

Qualifications

• Bachelor's degree in life sciences, business, healthcare administration, or related field; MBA or advanced degree preferred.
• 7+ years of experience within the pharmaceutical/biotech industry with a minimum of 3 years in patient services, case management operations, reimbursement hub operations, or payer/PBM operations.
• Deep expertise in commercial insurance structures, pharmacy benefit design, specialty drug access pathways, and the specialty pharmacy ecosystem.
• Demonstrated knowledge of AFP tactics, payer policies, TPA operations, and patient assistance program design and administration.
• Experience leading or overseeing hub-level case management operations.
• Exceptional analytical, problem-solving, and strategic thinking capabilities.
• Outstanding communication skills with demonstrated ability to counsel patients.

Requirements

• Strong understanding of HIPAA regulations, OIG guidance on patient assistance programs, ERISA, ACA Essential Health Benefit requirements.
• Proven ability to manage complex stakeholder relationships across internal and external partners.
• Experience with rare disease, transplant, or specialty pharmacy strongly preferred.
• Proficiency in case management systems, benefits verification tools, and data tracking/reporting platforms.

Benefits

• Wide range of health and wellbeing benefits including high-quality healthcare.
• Prevention and wellness programs.
• At least 14 weeks’ gender-neutral parental leave.

Company Description

Sanofi Inc. and its U.S. affiliates are Equal Opportunity and Affirmative Action employers committed to a culturally diverse workforce. All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, national origin, age, ancestry, nationality, marital status, sex, gender, gender identity or expression, affectional or sexual orientation, disability, veteran or military status.