Genesis Lugo
Marlborough,MA
Overview
10
10
years of professional experience
Work History
Case Management Specialist East
Sanofi Genzyme
Cambridge, MA
07.2025 - Current
- Manage complex rare disease patient cases across South Florida and Puerto Rico territory, providing end-to-end support from enrollment through therapy initiation and ongoing access maintenance
- Navigate payer requirements including prior authorizations, appeals, and reauthorizations to minimize delays in treatment access
- Partner cross-functionally with HCP offices, specialty pharmacies, and internal teams to resolve access barriers and streamline patient onboarding
- Interpret insurance benefits and identify appropriate financial assistance options, including copay and patient assistance programs (PAP)
- Serve as a primary point of contact for providers and patients, delivering timely updates and ensuring a high-touch, patient-centered experience
- Analyze case trends and escalate access issues, contributing to process improvements and more efficient case resolution
- Collaborate with specialty pharmacies and hubs to coordinate shipments, troubleshoot delays, and ensure continuity of care
Senior Patient Support Specialist
Vertex Pharmaceutical
Boston, MA
09.2019 - Current
- Provide ongoing support to 269 patients throughout their treatment journey with product education and living with CF resources to help them stay on track with their prescribed Vertex medicine.
- Build meaningful connections with external partners, including healthcare professionals(HCPs) and specialty
pharmacies (SP). - Apply strong troubleshooting skills to navigate access and adherence-related issues.
- Utilize analytics tools to proactively monitor and rapidly respond to trends.
- Delivered timely information to insurance representatives to resolve common and complex issues.
- Helped minimize escalations by reaching out to clients in advance of expected problems.
- Followed up on denied and unpaid claims to resolve problems and obtain payments.
- Furthered skills by actively taking part in employee training and taking classes to improve skills.
Case Manager
ALS Association Massachusetts Chapter
Westwood, MA
04.2018 - 09.2019
- Partnered with physicians, social workers, activity therapists, nutritionists and case managers to develop and implement individualized care plans and documented all patient interactions and interventions in electronic charting systems.
- Took active role in patient and family planning process, detailing instructions and responding appropriately and effectively to question and concerns.
- Educated patients and loved ones about different treatment options and outside care approaches, reducing burden on hospital resources.
- Assisted patients in understanding individual rights and responsibilities in regards to care, coverage and payment.
- Utilized knowledge of available resources to help patients select appropriate courses and obtain relevant support.
Geriatric Case Manager
Ethos
Jamaica Plain, MA
08.2016 - 03.2018
- Maintained average caseload of 115 clients.
- Conducted initial assessments of home care and personal needs.
- Through interviews and reassessed every two to six months Developed care plans and coordinated services with hospitals, certified agencies, hospices, and other supports.
- Acted as an advocate for clients in areas including Social Security, Medicare, Medicaid,housing, legal services, and fuel assistance.
- Monitored care plans and submitted authorizations as needed to adjust care plans to meet elder's needs.
- Completed narratives, Comprehensive Data Sets, and journal notes in accordance with EOEA guidelines and regulations within MA State SIMS database.
Education
Bachelor of Science - Psychology, Education Studies
Suffolk University
Boston, MA2013
Skills
- Insurance eligibility verification
- Data entry accuracy
- Patient satisfaction
- Patient confidentiality
- Escalation management
- Training & Development
- Fluent in two languages
Timeline
Case Management Specialist East
Sanofi Genzyme
07.2025 - Current
Senior Patient Support Specialist
Vertex Pharmaceutical
09.2019 - Current
Case Manager
ALS Association Massachusetts Chapter
04.2018 - 09.2019
Geriatric Case Manager
Ethos
08.2016 - 03.2018
Bachelor of Science - Psychology, Education Studies
Suffolk University