Mito Case Manager (MCM)

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.

We are looking for a Mitochondrial (Mito) Case Manager (MCM) who is empathic, collaborative and patient-focused when assisting patients' HCPs with the reimbursement journey to access to join 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

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