Hi, I’m
ELIZABETH TOGA
Summary
Results-driven case management professional with track record of effective client advocacy and support. Experienced in conducting thorough assessments and creating individualized care plans to meet client needs. Collaborates seamlessly with multidisciplinary teams and adapts to dynamic situations to ensure optimal client outcomes.
Overview
6
years of professional experience
Work History
Sarepta Therapeutics, Inc.
Case Manager
03.2022 - Current
Job overview
- Managed patient caseloads effectively, ensuring timely follow-up and appropriate interventions.
- Worked closely with patients/caregivers and providers to gain access to therapy.
- Built strong relationships with patients and families during difficult times, fostering resilience and coping skills.
- Worked with Specialty Infusion Pharmacies and HUB to obtain reimbursement coverage.
- Performed Benefit Investigations with insurance companies as required. Maintained knowledge of Medicare, Medicaid, and commercial plans coverage policies.
- Counseled patient/family on reimbursement options and financial assistance options. (Co-Pay, PAP)
- Managed the transition to home therapy as appropriate. Work closely with specialty infusion pharmacies and nursing agencies to coordinate reimbursement and supplies.
- Worked collaboratively with cross functional team's, and Managed Markets team.
- Answered patient and medical office inquiries to resolve customer problems.
- Attended patient meetings and represent organization at industry conferences.
- Maintained accurate documentation on all cases, ensuring compliance with regulations and confidentiality requirements.
BMR Partners Inc.-Specialty Care RX
Business Manager
09.2020 - 02.2022
Job overview
- Improved operational workflows by identifying areas of inefficiency and implementing appropriate solutions.
- Established and maintained professional relationships with targeted specialist to maximize new business opportunities.
- Enhanced communication between patients and providers through consistent follow-ups and progress updates.
- Executed on strategy with appropriate attention to detail and timely follow up.
- Collaborated with internal BMR operations personnel on a regular basis to ensure a proper flow of information between accounts and the pharmacy.
- Worked cross functionally with Marketing, Market Access, and reimbursement HUB to resolve complex coverage and reimbursement obstacles.
- Engaged in meaningful dialogue that addressed the needs of the health care provider's and patient's.
- Participation in exhibits to represent organization.
- Technical knowledge of health care reimbursement from a patient and provider perspective, in regards to prior authorizations, misc J Code, billing, coding, appeals, and denials.
- Educated physician offices regarding co-pay assistance.
- Knowledge of commercial payer's, Medicare, and Medicaid.
- Provided physicians and clinics reimbursement expertise, and be a subject matter on access resolution.
Sysco Wholesale Company
Account Sales Executive
05.2019 - 09.2020
Job overview
- Consistently achieved and grew institutional B2B sales by leveraging appropriate portfolio of medical products within a highly visible, high dollar territory with monthly sales of approximately 1 million dollars.
- Identified developed and maintained B2B relationships with appropriate C-Suite hospital customers responsible for purchasing institutional supplies.
- Recruited product advocates within each account to generate additional sales and share best practices amongst customer community.
- Educated key customers on product portfolio based on relevant business needs; provide product training, pricing and product recommendations based on market trends in order to deliver valuable solutions.
- Used strategic brand positioning focused on product superiority within a competitive market to create product demand and identify additional unmet needs in an account.
BioMarin
Case Manager-Intern
03.2019 - 06.2019
Job overview
- Performed benefit investigations, prior authorizations, and assisted with appeals/ denials.
- Single point of contact for patients/caregivers to offer support.
- Conducted thorough evaluations of client progress, adjusting case plans as needed to maximize success.
- Developed knowledge of HIPPA rules/regulations.
- Assisted patients/caregivers through resolution of denials, co-pay assistance, and foundation support.
- Triaged patient cases, built trusting relationships with patients, prescribers and sites of care.
- Streamlined case management processes by implementing efficient tracking systems for documentation and reporting purposes.
Education
CALIFORNIA STATE UNIVERSITYNorthridge, California
BACHELOR OF SCIENCE
05.2013
Skills
- Time management
- Critical thinking
- Organization and multitasking
- Relationship building
- Problem-solving
- Case management
- MS office
- Documentation and reporting
Languages
English
Native or Bilingual
Timeline
Case Manager
Sarepta Therapeutics, Inc.
03.2022 - Current
Business Manager
BMR Partners Inc.-Specialty Care RX
09.2020 - 02.2022
Account Sales Executive
Sysco Wholesale Company
05.2019 - 09.2020
Case Manager-Intern
BioMarin
03.2019 - 06.2019
CALIFORNIA STATE UNIVERSITY
BACHELOR OF SCIENCE
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