Job title: Director, Case Management - Community - West
Location: Cambridge, MA, Hybrid
It is expected that this hire be onsite in Boston 2-3 days a week
About the Job
Across the Rare Diseases our 'one team, common goals, single mission' new go-to-market (GTM) approach is leading the way. This new Rare Diseases GTM model highlights the need to reinvent and evolve the CM role with more accountability, responsibility, and strategic intent than ever before.
The Case Manager (CM) Directors will be required to elevate the performance of their teams, and coach to new skills, knowledge, behaviors and raise the team's contributions in our new play to win elite approach. Coaching to this elite mindset and performance means the Directors will need to demonstrate these same skills. CM Directors will manage and communicate key performance indicators (KPIs) to measure success and impact (reported monthly).
The new CM reporting to the CM Directors will need to:
Building expertise for 7 brands, 5 therapeutic areas, engage in account strategy and planning with galaxy and constellation teams (monthly), understanding market conditions that impact the patient journey (i.e. payer, government, Pharma, industry, access), understanding rare competitive products, advising the cross functional teams on the patient perspective, developing skills sets that will allow them to compliantly bring patient insights back to leadership reducing the need for external insights gathering, engage in launch preparations with insights and expertise. There will be a component of travel based on account needs and requests. Travel will be driven by cross functional galaxy or constellation teams.
Serve as a trusted member of their Divisional Rare Disease leadership team by providing the voice of the case management organization and people leadership of the Strategic Accounts Case Management Specialist team that supports the patients within the division.
Lead the divisional team that is responsible for providing best-in-class personalized patient services to ensure a positive patient experience in support of Sanofi Rare Disease business priorities.
Driven by the complexity of patient identification, treatment administration intricacies, and access gateways, this role must coordinate both internal and external care teams in the overall patient journey. The Case Management Specialist team supports the entire Rare Disease portfolio.
The Director is responsible for overseeing and managing their team, guiding, coaching and training, developing policies, procedures, and measuring performance including individual metrics and KPIs, establishing and adhering to budgets, communicating with physicians, staff, and patients as applicable, coordinating with third-party vendor partners, working collaboratively with Specialty Pharmacy partners. This role will also be responsible for ensuring business metrics are measured and met, as well as working within the strategic framework provided by the business. They will also ensure their teams provides best-in-class patient services to create a positive patient experience and support Sanofi business priorities.
We are an innovative global healthcare company, committed to transforming the lives of people with immune challenges, rare diseases and blood disorders, cancers, and neurological disorders. From R&D to sales, our talented teams work together, revolutionizing treatment, continually improving products, understanding unmet needs, and connecting communities. We chase the miracles of science every single day, pursuing progress to make a real impact on millions of patients around the world.
Main Responsibilities:
Lead team responsible for:
Acting with a sense of urgency and purpose, leading the case management process, while balancing the needs of individual patients to align with the business objectives of Sanofi, the Rare Disease business and Specialty Care Patient Support Services
Serving as point of contact and champion for patient from enrollment through to infusion
Assessing individual patients' insurance coverage options or limitations and requirements, identifies appropriate resource plans and advocates on patient's behalf to ensure successful initiation of rare treatment
Educating patients, caregivers and health care providers on product coverage based on patient benefits and the steps needed to gain product and administration approval
Maintaining comprehensive understanding of the reimbursement process, navigation of health care systems, billing/coding guidelines, insurance plans, payer trends, internal and external patient assistance programs, and related resources.
Coordinating with different sites of care, including infusion centers
Managing the transition from infusion site to in-home infusion therapy as appropriate
Enrolling eligible patients into appropriate financial assistance programs as needed/required.
Business Leadership Responsibilities include:
Maintaining up-to-date knowledge of the resources available at the regional/divisional level as well as market landscape and applying this knowledge in way that best supports patient access to therapy.
Compliantly coordinating the exchange of patient-related information with internal and external stakeholders.
Exhibiting initiative and leadership within the cross-functional regional team. Able to consistently identify complex patient specific issues and develop action plans accordingly.Demonstrates accountability for action plan execution, and energetically drives for success and results.
Establishing and maintaining professional and effective relationships with all internal and external customers and stakeholders, including but not limited to case management team and patient support services colleagues, medical, sales, market access, pharmacovigilance, specialty pharmacies, healthcare providers and staff, and infusion sites.
Attending meetings and conferences to educate individuals regarding services and other approved case management topics. Represent Sanofi in all venues in a professional manner.
Raising your own performance expectations and goals to support entrepreneurial approach to the growth of the team and the business.
Demonstrating and maintaining a high level of business acumen, understanding of Sanofi's business model, and the role of the case manager and patient support services team in driving initiatives to meet goals.
Demonstrating innovation by consistently monitoring systems, processes, and potential gaps, offering new ideas and solutions to elevate the support program.
Effectively sharing reimbursement and other knowledge with PSS members through orientation training, case studies, consultation for complex cases, and special projects as requested.
Consistently documenting and maintaining accurate data, including insurance, coverage approvals, on-going coverage requirements, and all patient, caregiver, provider and matrix team interactions.
The ongoing in roll development of each direct report - via an inspiring culture and benchmarking excellent performance, consistent coaching from observed patient and HCP engagement, alignment on expectations and development goals, ongoing feedback and positive reinforcement or performance management.
Demonstrating proficiency in use of CRM tool to document work. Consistently leverages CRM reporting tools and data analytics to make strategic territory decisions while prioritizing patient and customer needs.
Providing caseload coverage outside of assigned territory as needed.
Complying with Sanofi policies.
Recording and reporting Adverse Events and Product Complaints
Assessing risk and evaluating potential for patient case deviation and communicating and suggesting contingencies.
Additional Leadership responsibilities include:
Hiring, training, onboarding, coaching and performance management for a team of case managers
Handling case management process, balancing the needs of individual patients, Patient services priorities and aligning with the business needs/objectives of the business
Ensuring close and compliant coordination and partnership with other field matrix teams supporting Rare Disease
Balancing caseload coverage and adjusting territory workload as needed.
Ongoing monitoring of KPI and metrics, working with business to adjust priorities as well as plans to ensure measures are met
Completing quality call calibration and manage deviations.
Ensure compliance with Sanofi policies
About You
Qualifications:
Bachelor's Degree (general business, health sciences, public policy, or other related degrees)
5+ years of patient-facing or high touch customer interaction/case management experience required.
3+ years of team lead or supervisory experience
In-depth understanding of health insurance benefits, relevant state and federal laws and insurance regulations.
Excellent written and oral communication, mediation, and problem-solving skills, including the ability to connect with patients, caregivers and providers.
Experience and demonstrated success working in a complex matrix to accomplish goals
Strong people skills that demonstrate flexibility, persistence, creativity, empathy and trust.
Computer literacy skills including data entry and office-based software programs.
Ability to identify and handle sensitive issues, working independently and collaboratively within teams.
Knowledge of guidelines relating to compliant medical communications
Ability to travel, up to 10%.
Preferred Qualifications:
Bi-lingual; Spanish language skills preferred
Salesforce CRM experience
Pharma/biotech patient services and specialty product experience
Experience with complex medical payer policy requirements and coordination of multiple prior authorization needs for one case
Rare disease experience preferred
Experience with varied methods of drug acquisition and administration
This position is based in Cambridge, MA and offers a flexible, hybrid work schedule.
Why Choose Us?
Bring the miracles of science to life alongside a supportive, future-focused team.
Discover endless opportunities to grow your talent and drive your career, whether it's through a promotion or lateral move, at home or internationally.
Enjoy a thoughtful, well-crafted rewards package that recognizes your contribution and amplifies your impact.
Take good care of yourself and your family, with a wide range of health and wellbeing benefits including high-quality healthcare, prevention and wellness programs and at least 14 weeks' gender-neutral parental leave.
Sanofi Inc. and its U.S. affiliates are Equal Opportunity and Affirmative Action employers committed to a culturally diverse workforce. All qualified applicants will receive consideration for employment without regard to race; color; creed; religion; national origin; age; ancestry; nationality; marital, domestic partnership or civil union status; sex, gender, gender identity or expression; affectional or sexual orientation; disability; veteran or military status or liability for military status; domestic violence victim status; atypical cellular or blood trait; genetic information (including the refusal to submit to genetic testing) or any other characteristic protected by law.
