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Case Manager

Tailored Management Services Inc Texas, US (Onsite) Full-Time

Job Title: Case Manager
Pay Rate: $21/hour – Paid Weekly!
Location: 100% Remote
Schedule: Contract to hire | 8-hour shift between 7 AM – 7 PM CST
Training: Virtual, Mon–Fri, 8 AM – 5 PM CST for 4–6 weeks (no time off during training)


About the Role:
This role supports specialty pharmaceutical manufacturers in helping patients access life-changing therapies faster. As a Case Manager, you’ll guide patients from benefit verification through medication delivery and working closely with providers, pharmacies, and insurance companies to remove barriers to care.


Key Responsibilities:

  • Monitor system accounts for new patient cases and manage them from initial contact through final approval or denial.

  • Conduct outbound calls to confirm insurance coverage, co-pays, and specialty pharmacy details with patients.

  • Contact insurance companies to obtain and document accurate benefit information.

  • Mediate and resolve complex payer or pharmacy issues to achieve positive outcomes.

  • Maintain empathetic, professional communication with patients, providers, and physician offices.

  • Answer and resolve patient questions regarding the status of their requests for assistance.

  • Enter detailed case notes in proprietary software while speaking with patients or healthcare staff.

  • Research alternative funding options and determine patient eligibility.

  • Identify, document, and compliantly submit Adverse Events when applicable.

  • Provide updates to team members and leadership on case progress.


What We’re Looking For:

  • Healthcare, insurance, or pharmaceutical industry experience – preferred

  • Pharmacy Benefits Management (PBM) experience with Medicare, Medicaid, and commercial payer policies – preferred

  • Prior authorization and appeals experience – highly desired

  • Strong Microsoft Office and data entry skills

  • Ability to type 40+ WPM while talking to patients

  • Excellent communication and problem-solving skills


Remote Requirements:

  • Quiet, private workspace

  • Hardwired high-speed internet (15 Mbps download / 5 Mbps upload)

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Job Snapshot

Employee Type

Full-Time

Location

Texas, US (Onsite)

Job Type

Other

Experience

Not Specified

Date Posted

08/15/2025

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