Case Manager, Rare

Company: Alnylam Pharmaceuticals
Location: Cambridge
Posted on: May 16, 2025

Job Description:

This role is considered Virtual.Overview We are continuing to build out our US Patient Services team to provide exceptional customer service on all levels. Reporting to a Regional Manager, the Case Manager (CM) is a non-sales regional field-based position that will be responsible for providing a smooth customer interaction from intake through supporting continued patient access to therapy by educating physicians, genetic counselors, nurses, pharmacists and ancillary staff, as well as patients, caregivers, and families to address and prevent barriers to patient access. The CM's focus will be to optimize access to Alnylam products in his/her region by understanding and addressing patient access challenges. This position requires a professional who can leverage their expertise and experience to manage access issues as patient-specific therapy is initiated and leading action plans to resolve access issues as they arise post-therapy initiation.A key component of this role is the ability to establish and deepen customer relationships through quality interactions. The CM will also utilize a regional team approach while working with numerous internal cross-functional partners such as; Patient Services team members, Market Access, Field Sales, Strategic Accounts, Patient Advocacy and Marketing to facilitate and optimize patient carewhile supporting Alnylam's patient-focused vision of harnessing a revolution in biology for human health.The successful candidate must exhibit technical knowledge of health care reimbursement from a patient/provider perspective as well as the ability to interact with physicians, staff, and sites of care.They must also possess a positive attitude, be passionate about science and deeply motivated by the quest of delivering value to patients and their families with the long-term success of the company in mind.The CM will manage the logistical issues impacting treatment initiation and ongoing therapy while demonstrating an understanding of the company's business objectives and measures and working independently as well as collaboratively within a highly matrixed environment.Key Responsibilities

• Assess patients' needs and develop action plans that provide for the initiation and
  continuation of treatment with Alnylam products while coordinating the exchange of all
  applicable patient-related information with appropriate internal and external stakeholders.
• Develops a comprehensive understanding of the reimbursement process, billing/coding
  nuances, insurance plans, payer trends, financial assistance programs, patient
  assistance programs, and related resources.
• Assists in obtaining insurance approval for Alnylam products, and proactively plans for
  maintenance of coverage by working with patients and their caregivers/families,
  healthcare providers, insurance companies, specialty pharmacies, and Alnylam colleagues.
• Understands the resources available in their specific region, and how they can be best employed to support patient care.
• Identifies complex patient-specific issues and develops and executes action plans accordingly.
• Maintains disease, reimbursement and insurance coverage expertise through continuing
  medical education and attendance at relevant conferences and other educational opportunities.
• Educates patients, caregivers, family members, health care providers, and others
  regarding insurance options and limitations, including PA and policy requirements necessary to initiate and maintain treatment, patient services' offerings and relevant disease/product
  information as necessary.
• Fosters collaborative relationships with all internal and external customers including but
  not limited to Patient Education Liaisons, medical, sales, field reimbursement, corporate
  accounts, patient advocacy, insurance company case managers, specialty pharmacies,
  home health agencies, and office coordinators.
• Attend patient meetings and represent Alnylam at industry conferences, as needed
• Ensures compliance with all corporate and industry policies in collaboration with Alnylam Legal, Regulatory and Compliance.Qualifications
  • Bachelor's Degree required. Health Care/Social Work/Nursing (or related field) a plus.
  • 3+ years recent case management experience in the healthcare or pharmaceutical/biotech industry. Ultra-rare disease experience a plus.
  • Experience should include but not be limited to 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 process for infused and injectable products.
  • Knowledge of private payer, Medicare, and Medicaid structure, systems, and reimbursement process required.
  • Experience and proficiency in working with a Customer Relationship Management System, such as Salesforce.com.
  • Possess strong written and verbal communication skills, exceptional listening, critical thinking, problem solving, negotiation and mediation skills.
  • 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 effective in influencing without authority.
  • Desire to innovate and work in a fast-paced, flexible, and energetic environment.
  • Self-starter who is highly passionate about rare disease and Alnylam's core values:
    • Commitment to People, Innovation and Discovery, Sense of Urgency, Open Culture, and Passion for Excellence.
    • Ability to travel 5%, including weekends/evenings, as needed.About Alnylam:Alnylam Pharmaceuticals (Nasdaq: ALNY) has led the translation of RNA interference (RNAi) into a whole new class of innovative medicines with the potential to transform the lives of people afflicted with rare and more prevalent diseases. Based on Nobel Prize-winning science, RNAi therapeutics represent a powerful, clinically validated approach to treating diseases at their genetic source by "interfering" with mRNA that cause or contribute to disease. Since our founding in 2002, Alnylam has led the RNAi Revolution and continues to turn scientific possibility into reality.Our culture:Our people-first culture is guided by our core values: fiercely innovative, open culture, purposeful urgency, passion for excellence, and commitment to people, and these values influence how we work and the business decisions we make. Thanks to feedback from our employees over the years, we've been fortunate to be named a top employer around the world. Alnylam is extremely proud to have been recognized as the #1 Large Employer by Boston Globe Top Places to Work in 2023 for the third consecutive year, one of Science Magazine's Top Biopharma Employers, one of America's Most Responsible Companies for 2024 by Newsweek, a Fast Company Best Workplace for Innovators, and a Great Place to Work in Canada, France, Italy, Spain, Switzerland, and UK - among others.At Alnylam, we commit to an inclusive recruitment process and equal employment opportunity. We are dedicated to building an environment where employees can feel that they belong, can bring their authentic selves to work, and achieve to their full potential. By empowering employees to embrace their unique differences at work, our business grows stronger with advanced and original thinking, allowing us to bring groundbreaking medicines to patients. Qualified applicants will receive consideration for employment without regard to their race, color, religion, age, sex, sexual orientation, gender identity or expression, national origin, ethnicity, marital status, protected veteran status, disability, or any other characteristics prohibited by law. > Required
      Preferred

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Keywords: Alnylam Pharmaceuticals, Cambridge , Case Manager, Rare, Executive , Cambridge, Massachusetts