Manager, Case Management

Management         ·        San Diego, CA         ·        Full time

This position is located onsite in San Diego.

Mainstay Medical

Mainstay Medical is a medical device company focused on marketing an innovative implantable neurostimulation system, ReActiv8®, for people with disabling chronic mechanical Low Back Pain. The company is headquartered in Dublin, Ireland, with subsidiaries operating in Ireland, the United States, Australia, Germany, and the Netherlands.

The Role

Reporting to the Director, Market Development and Access, with the primary responsibility of managing and developing Mainstay Medical Patient Access Program and its associated teams.  The Patient Access Program team will consist of clinical liaisons that operate remotely to support patient awareness and education on ReActiv8 as well as staff that will support the prior authorization process including all appeals.

Position Responsibilities:

• Develop, train, and lead all Mainstay Medical Patient Access Program team members which shall include clinical liaisons and prior authorization specialists.
• Develop and implement continuing education and necessary training of Mainstay Medical Patient Access Program team.
• Support team members as a Subject Matter Expert in prior authorization processes and appeals processes to secure pre-service review of ReActiv8.
• Directly partner with the field sales team to support program awareness, efficiency, uptake, and customer satisfaction.
• Utilize programmatic data and analytic capabilities to drive employee productivity and functional stakeholder insights that improve overall performance.
• Assist with necessary updates to Sales Force platform to ensure proper workflow, visibility and territory alignment.
• Work closely with additional departments to ensure the overall process is running smoothly and efficiently and provide strategic insight to areas of improvement.
• Collaborate with field sales to ensure patient barriers are removed or addressed, and internal and external resources are aligned to facilitate the process.
• Manages multiple priorities and deadlines successfully and handles stressful situations accordingly. Accepting risk and uncertainty.
• Ensure compliance with company compliance policy, in particular patient confidentiality (HIPAA) in all Mainstay Medical practices.
• Perform other duties as required.

Qualifications:

• Associate’s Degree (heath economics, life sciences or public health) required. Bachelor’s degree strongly preferred.
• Experience in a medical office or hospital setting with coding and prior authorization experience or experience implementing patient access programs.
• Typically has 7 or more years of experience with 2 or more years of management experience.
• Knowledge of health insurance industry practices/functions to include Medicare, Medicaid, and all types of commercial and managed care organization’s coverage policies.
• Skilled at patient engagement and interaction; experience in patient education is a plus. 
• Demonstrate excellent organizational skills with attention to detail.
• Clear written and verbal communication skills, both in-person and over the phone. 
• Knowledge and skillset around leveraging and utilizing the Salesforce platform, including system tools, integration components, reporting, etc.
• Experience with digital tools to enhance process efficiency (i.e., DocuSign, web-based forms, etc.)
• Proficient in computer operations, including Microsoft Word, Outlook, Excel, PowerPoint, and basic database management. 
• Problem solver and capable to find solutions to challenges or process impediments.
• Maintains a caring, empathetic, and patient-centric approach in all interactions.

The salary range for this position is $99,000 to 150,000/year; however, base pay offered will take into account a range of factors, including job-related knowledge, skills, and experience. The total compensation package includes a range of medical, dental, vision, financial, and other benefits, as well as equity.

Mainstay Medical is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to gender, race, color, religious creed, national origin, age, sexual orientation, gender identity, physical or mental disability, and/or protected veteran status. Mainstay Medical participates in E-Verify.

Please click here to apply.