Case Manager

Contract position for 6 months with possibility of extension, offered through Kelly Services. Remote role for U.S.-based candidates within 100 miles of Columbus, OH.

About the Role

The Case Manager acts as a liaison between patients, providers, distributors, and insurance carriers to ensure services are provided in the least restrictive and most cost-effective manner. Responsibilities include providing reimbursement support to patients, pharmacists, physicians, and the internal sales force, as well as educating and assisting patients and providers to navigate the reimbursement and appeal processes. This role identifies barriers to reimbursement and facilitates referrals to alternative coverage options and financial assistance programs for patients who are underinsured or require copay assistance. The position is an individual contributor role reporting to a supervisor.

Responsibilities

• Provide reimbursement support to patients, pharmacists, physicians, and the internal sales force.
• Educate and assist patients and providers in navigating reimbursement and appeal processes.
• Identify barriers to reimbursement and facilitate referrals to alternative coverage options and financial assistance programs.
• Demonstrate effective problem-solving skills and excellent customer service.
• Exhibit strong investigational and analytical abilities with proficient written and verbal communication.
• Work collaboratively in a team, delegate tasks effectively, and display leadership.
• Maintain strong attention to detail, organizational skills, and time management.
• Work efficiently under pressure, prioritize tasks, and follow written Standard Operating Procedures.
• Be prepared for periodic mandatory overtime, including weekends, during peak referral seasons or unexpected volume surges.

Requirements

• Bachelor’s degree preferred.
• At least three years of reimbursement experience preferred.
• Knowledge of the managed care industry, including government payers, is strongly desired.
• Proficiency in all aspects of reimbursement, including benefit investigations, payer reimbursement policies, and regulatory or administrative rules.
• Understanding of reimbursement and funding resources and how to access them.
• Must maintain a dedicated, distraction-free workspace with a closing door, separate from common living areas.
• Must have a high-speed internet connection reliable enough for all job duties.
• Ensure all phone conversations involving Protected Health Information (PHI) cannot be overheard by third parties and that computer screens are not visible to others.
• All work must be conducted exclusively via the corporate VPN; local data downloads, unapproved caching, or local tokenization of sensitive records is strictly prohibited.
• Full compliance with HIPAA, Sensitive Personal Information (SPI) consent governance, and all regional data privacy laws is required at all times.
• Initial training and/or onboarding may require up to one week of travel, communicated in advance.

Pay

$27 to $33 per hour. Actual pay will be determined based on experience, qualifications, geographic location, and other job-related factors permitted by law.

Benefits

• Voluntary benefit plans including medical, dental, vision, telemedicine, term life, whole life, accident insurance, critical illness, and a legal plan.
• Retirement savings plan.
• Service bonus and holiday pay plans (earn up to eight paid holidays per benefit year).
• Transit spending account.
• Paid sick leave under the applicable state or local plan.