[Hiring] Case Manager @TEKsystems

Role Description

The Case Manager will serve as an expert in benefit coordination and patient support, managing interactions with healthcare providers, patients, and specialty pharmacies. In this fully remote role, you will guide patients and providers through pharmaceutical benefit processes, support program enrollment and affordability options, and act as a key liaison between internal program teams and external stakeholders.

• Serve as a subject matter expert on all aspects of benefit coordination and available patient support resources.
• Handle telephony and email communications with patients, physicians' offices, and specialty pharmacies for both inbound and outbound call types.
• Support healthcare providers and patients by explaining eligibility requirements, program enrollment processes, and affordability support for prescribed therapies.
• Establish and maintain strong relationships, trust, and rapport with healthcare providers and patients through consistent, professional communication.
• Act as a primary point of contact to healthcare providers, delivering detailed information regarding program offerings and individual patient cases.
• Demonstrate strong working knowledge of benefits across payer types, including private/commercial plans and government programs such as Medicare, Medicaid, VA, and DoD, with particular expertise in Medicare Part B.
• Navigate payer challenges by asking targeted, appropriate questions to obtain the necessary information and achieve positive outcomes.
• Act as a liaison between client contacts and internal program teams, including serving as a regional contact for field representatives when applicable.
• Maintain accurate and compliant records in accordance with applicable standards, regulations, and program requirements.
• Follow program guidelines and escalate complex or atypical cases in line with standard operating procedures (SOPs), call guides, and other program materials.
• Collaborate closely with Program Management and other internal stakeholders on a daily basis to maintain open communication about patient status, prescriber feedback, coordination challenges, and program effectiveness.
• Provide high-quality customer service with strong attention to detail while serving as a brand and program advocate.
• Demonstrate an understanding of the disease states relevant to the program's patient population to better support patient needs.
• Assess situations proactively and intervene when necessary to ensure timely resolution and access to therapy.
• Maintain a high level of ethical and professional conduct, particularly regarding confidentiality and privacy of patient and provider information.
• Support a positive team culture by consistently demonstrating a strong work ethic, positive attitude, and collaborative approach.
• Utilize available resources and appropriate channels for conflict resolution when issues arise.
• Ensure consistent adherence to all SOPs and corporate policies, including on-time completion of required training and compliance modules.
• Perform additional tasks, duties, or special projects as assigned to support overall program success.

Qualifications

• 2+ years of experience in pharmaceutical benefit processes.
• 2+ years of experience in HUB or patient services roles.
• Previous experience working in a contact center environment.
• Hands-on experience with pharmaceutical benefit processes across multiple payer types.
• Experience with medical benefit processes, including exposure to Medicare, Medicaid, VA, and DoD, with expertise in Medicare Part B.
• Proven ability to manage both inbound and outbound calls in a high-volume, service-oriented setting.
• Demonstrated experience providing phone-based support and customer service.
• Strong customer service skills with the ability to communicate clearly and professionally with patients and healthcare providers.
• Experience with insurance verification or similar benefit investigation activities.
• Ability to follow detailed SOPs, call guides, and program materials consistently.
• Strong organizational skills with the ability to maintain accurate and compliant documentation.
• High level of professionalism, ethics, and respect for confidentiality and privacy requirements.
• Ability to work collaboratively with program management and cross-functional teams in a remote environment.

Additional Skills and Qualifications

• Experience supporting patient services or HUB programs for specialty therapies.
• Familiarity with affordability programs, patient assistance programs, and reimbursement support.
• Comfort navigating payer policies, coverage criteria, and prior authorization or appeals processes.
• Strong problem-solving skills with the ability to assess complex situations and determine appropriate next steps.
• Ability to build rapport quickly with patients and healthcare providers through empathetic and clear communication.
• Demonstrated conflict resolution skills and ability to de-escalate challenging interactions.
• Positive attitude and resilience in a fast-paced, metrics-driven environment.
• Willingness to take on additional tasks or projects as needed to support program goals.

Job Type & Location

This is a Contract position based out of Morrisville, NC.

Pay and Benefits

The pay range for this position is $21.00 - $22.00/hr. Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors.

• Medical, dental & vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave)

Application Deadline

This position is anticipated to close on Nov 6, 2026.

Workplace Type

This is a fully remote position.