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Provide best-in-class support services to ensure a positive experience for patients receiving Tzield, Sanofi's first and only disease-modifying therapy for type 1 diabetes (T1D). Tzield is approved to delay the onset of Stage 3 T1D in adults and children one year and older diagnosed with Stage 2 T1D. This role requires coordinating both internal and external care teams throughout the patient journey, addressing the complexities of patient identification, treatment administration, and access challenges. As a Case Manager for Tzield, you will support T1D patients and their families through insurance verifications and comprehensive care coordination. In this high-touch role, you will assist patients and caregivers with accessing Sanofi's FDA-approved T1D therapy, facilitating insurance approvals for both the product and administration, collaborating across multiple functions, and coordinating care to ensure a seamless journey. You will serve as the central point of contact, developing and executing personalized care plans to address patient barriers to treatment, providing relevant program and process education, resources, and coordination throughout the patient journey.
Job Responsibility:
Act with a sense of urgency and purpose, leading the case management process for Tzield patients, while balancing individual patient needs with Sanofi's business objectives
Conduct Insurance Verifications for Tzield patients
Serve as the primary point of contact and champion for patients from enrollment through to treatment completion
Engage patients/families to create meaningful connections, uncover needs, understand challenges, and provide education and support to start on Tzield therapy
Assess individual patients' insurance coverage options, limitations, and requirements
identify appropriate resource plans and advocate on patients' behalf to ensure successful initiation of Tzield treatment
Educate patients, caregivers, and healthcare providers on Tzield coverage based on patient benefits and the steps needed to gain product and administration approval
Maintain comprehensive understanding of the reimbursement process, healthcare systems navigation, billing/coding guidelines, insurance plans, payer trends, and internal/external patient assistance programs
Enroll eligible patients into appropriate financial assistance programs as needed
Maintain up-to-date knowledge of regional resources and market landscape to best support patient access to therapy
Compliantly coordinate the exchange of patient-related information with internal and external stakeholders
Exhibit initiative and leadership within the cross-functional regional team, identifying complex patient-specific issues and developing action plans accordingly
Document all interactions with attention to data integrity
Provide caseload coverage outside of assigned territory as needed
Ensure compliance with all Sanofi policies
Requirements:
Bachelor's degree required (any field)
1+ years minimum experience in pharma, healthcare, insurance, or related fields
In-depth understanding of health insurance benefits
Excellent written and oral communication and problem-solving skills, including the ability to connect with patients and caregivers
Experience and demonstrated success working in a complex matrix environment to accomplish goals
Strong people skills demonstrating flexibility, persistence, creativity, empathy, and trust
Ability to identify and handle sensitive issues, working independently and collaboratively within teams
Ability to travel within the US, up to 10%
Nice to have:
Salesforce CRM experience
Insurance Verification Experience
Direct experience in case management, reimbursement, insurance, or healthcare systems fields
Pharma/biotech patient services and specialty product experience
Experience with complex medical payer policy requirements and coordination of multiple prior authorization needs
What we offer:
Health and wellbeing benefits including high-quality healthcare, prevention, and wellness programs