Reimbursement Case Manager

McKesson is an impact-driven, Fortune 10 company that touches virtually every aspect of healthcare. We are known for delivering insights, products, and services that make quality care more accessible and affordable. Here, we focus on the health, happiness, and well-being of you and those we serve – we care.What you do at McKesson matters. We foster a culture where you can grow, make an impact, and are empowered to bring new ideas. Together, we thrive as we shape the future of health for patients, our communities, and our people. If you want to be part of tomorrow’s health today, we want to hear from you.At Biologics by McKesson, our mission is to simplify access to medication and deliver personalized care that helps patients achieve the best-possible outcomes — one patient, one partner, one therapy at time.Role OverviewThe Reimbursement Case Manager serves as the primary liaison between patients, caregivers, healthcare providers, payers, specialty pharmacies, manufacturers, and internal hub teams to facilitate timely access to prescribed therapies. This role is responsible for reimbursement support, patient access services, and case management activities throughout the patient journey.The Reimbursement Case Manager conducts benefit investigations, prior authorization support, appeals coordination, and financial assistance program enrollment while providing high-touch support to patients and healthcare providers. This position works in a fast-paced, high-volume environment and is responsible for identifying and overcoming reimbursement barriers, coordinating patient support services, and ensuring a seamless experience from referral through treatment initiation and ongoing therapy support.Reporting to the Supervisor of Hub Services, the Reimbursement Case Manager regularly interfaces with patients, providers, insurance companies, specialty pharmacies, manufacturer representatives, and internal support teams.Location: This is a hybrid role based out of Cary, NC. Employee will be required in office two days a week.Compensation: Target rate for this role is between $25 and $26 an hour along with a 5% yearly bonus.Key ResponsibilitiesReimbursement and Insurance SupportContact commercial, Medicare, Medicaid, and other payers to verify patient eligibility, benefits, and product-specific coverage information.Conduct comprehensive benefit investigations, including verification of medical and pharmacy benefits, patient financial responsibility, and coverage requirements.Obtain payer-specific prior authorization requirements, coverage criteria, documentation requirements, and utilization management guidelines.Coordinate and facilitate prior authorization submissions with healthcare providers and payer organizations.Monitor authorization status and proactively follow up with providers, payers, and specialty pharmacies to obtain timely determinations.Assist with appeal submissions, reconsiderations, and coverage exception requests for denied therapies.Provi...