Case Manager, West Coast

About the Company

Alnylam (Nasdaq: ALNY) is delivering on a bold vision to turn scientific possibility into reality with a robust RNA interference (RNAi) therapeutics platform. As the pioneer in RNAi and the leading RNAi therapeutics company, Alnylam is uncompromisingly dedicated to translating breakthrough science into transformational medicines to help as many people as possible. Focused initially on rare and genetic diseases, scientific advances now allow the company to expand the power of RNAi therapeutics to more prevalent diseases.

Founded in 2002 and headquartered in Cambridge, Mass., Alnylam has over 1,650 employees worldwide. The company is committed to becoming a top 5 independent, global biopharma company, recognized for its dedication to patients, innovative culture, scientific excellence, social responsibility, and commercial success. Alnylam has received numerous accolades, including being named one of Fast Company’s 2021 Best Workplaces for Innovators, a Science Magazine Top Employer (2019–2021), and a Boston Globe Top Places to Work (2015–2021).

Responsibilities

• Assess patients’ needs and develop action plans for the initiation and continuation of treatment with Alnylam products, coordinating all applicable patient-related information with internal and external stakeholders.
• Develop a comprehensive understanding of the reimbursement process, billing/coding nuances, insurance plans, payer trends, financial assistance programs, patient assistance programs, and related resources.
• Assist in obtaining insurance approval for Alnylam products and proactively plan for maintenance of coverage by working with patients, caregivers, healthcare providers, insurance companies, specialty pharmacies, and Alnylam colleagues.
• Understand regional resources and how they can best support patient care.
• Identify complex patient-specific issues and develop and execute action plans accordingly.
• Maintain expertise in disease, reimbursement, and insurance coverage through continuing medical education and attendance at relevant conferences.
• Educate patients, caregivers, family members, healthcare providers, and others on insurance options, policy requirements, patient services, and disease/product information.
• Foster collaborative relationships with internal and external stakeholders, including Patient Education Liaisons, medical and sales teams, field reimbursement, corporate accounts, patient advocacy groups, insurance case managers, specialty pharmacies, home health agencies, and office coordinators.
• Attend patient meetings and represent Alnylam at industry conferences as needed.
• Ensure compliance with all corporate and industry policies in collaboration with Alnylam Legal, Regulatory, and Compliance teams.

Requirements

• Bachelor’s Degree required; Health Care, Social Work, Nursing, or related field preferred.
• 3+ years of recent case management experience in healthcare or the pharmaceutical/biotech industry; ultra-rare disease experience a plus.
• Experience in home care management, case management review, utilization review, social service support, insurance reimbursement, patient assistance programs, or billing and coding.
• Knowledge of benefit verification and prior authorization processes for infused and injectable products.
• Understanding of private payer, Medicare, and Medicaid structure, systems, and reimbursement processes.
• Proficiency in working with Customer Relationship Management (CRM) systems, such as Salesforce.com.
• Strong written and verbal communication skills, exceptional listening, critical thinking, problem-solving, negotiation, and mediation abilities.
• Ability to navigate difficult conversations and handle sensitive issues with opposing opinions.
• Ability to work independently and manage competing priorities.
• Experience working in cross-functional teams and influencing without authority.
• Desire to innovate and thrive in a fast-paced, flexible, and energetic environment.
• Alignment with Alnylam’s core values: Commitment to People, Innovation and Discovery, Sense of Urgency, Open Culture, and Passion for Excellence.
• Ability to travel up to 5%, including weekends and evenings, as needed.

Pay

U.S. pay range: $85,500.00 – $115,600.00 for full-time base salary. Base pay is determined based on relevant experience, skills, and education. This role is eligible for an annual short-term incentive award (e.g., bonus or sales incentive) and an annual long-term incentive award (e.g., equity).

Benefits

• Comprehensive medical, dental, and vision coverage.
• Life and disability insurance.
• Lifestyle reimbursement program.
• Flexible spending and health savings accounts.
• 401(k) with a generous company match.
• Paid time off, wellness days, holidays, and two company-wide recharge breaks.
• Generous family resources and leave policies.

About Alnylam

Alnylam is the leader in RNAi therapeutics, a revolutionary approach with the potential to transform lives. Built on Nobel Prize-winning science, the company is at the forefront of delivering breakthroughs in RNAi therapeutics. With a deep pipeline and late-stage programs, Alnylam’s culture is rooted in fierce innovation, passion for excellence, purposeful urgency, openness, and a commitment to people. The company is recognized globally as a top employer, fostering an authentic and inclusive culture where breakthrough thinking thrives.