Senior Coordinator, Individualized Care (Case Manager)

Senior Coordinator, Individualized Care (Case Manager)

Cardinal Health Sonexus™ Access and Patient Support helps specialty pharmaceutical manufacturers remove barriers to care so that patients can access, afford and remain on the therapy they need for a better quality of life. Our diverse expertise in pharma, payer and hub services allows us to deliver best-in-class solutions—driving brand and patient markers of success. We’re continuously integrating advanced and emerging technologies to streamline patient onboarding, qualification and adherence. Our non-commercial specialty pharmacy is centralized at our custom-designed facility outside of Dallas, Texas, empowering manufacturers to rethink the reach and impact of their products.

Together, we can get life-changing therapies to patients who need them—faster.

Responsibilities

• Monitor system accounts for new Patient cases

• Conduct outbound calls to patients to confirm approval/denials of coverage, co-pays and verification of specialty pharmacy that will dispensing their medication

• Contact insurance companies as required to obtain and enter accurate benefit information to positively impact insurance processing and minimize rejections

• Mediate effective resolution for complex payer/pharmacy issues toward a positive outcome to de-escalate

• Place outbound calls to patients to assess for eligibility for co-pay and financial assistance

• Answer minimal inbound calls from doctors and/or patients checking on status of case

• Maintain quality while providing an empathetic and supportive experience to the patients, providers, and physician offices

• Resolve patient's questions and concerns regarding status of their request for assistance

• Enter detailed information into company proprietary software while conversing via telephone

• Steward patient accounts from initial contact through final approval/denial

• Process all patient applications in accordance to set policy, procedures and PHI compliance

• Speak with manufacturer field team members on case updates via phone or by email

• Works internally with team members regarding patients’ cases

• Ability to identify, document and submit Adverse Events during customer contact or via received documentation

• Conduct research associated with alternative funding or foundations to ensure patient has required information to receive product

Qualifications

• Minimum of HS diploma; additional education preferred

• Previous healthcare experience with insurance or in pharmaceutical industry, preferred

• Pharmacy benefits management experience preferred with specific knowledge of Medicare, Medicaid and commercially insured payer common practices and policies, preferred

• Previous prior authorization and appeals experience highly desired

• Knowledge of ICD coding, preferred

• Intermediate Microsoft skills with specific experience with Excel

• Organized with the ability to prioritize multiple, concurrent assignments and work with a sense of urgency

• Exceptional communication skills both verbally and written

• Self-starter with demonstrated initiative, creativity and a willingness to learn

• Must be willing to work 10a-7p CST

What is expected of you and others at this level

• Effectively applies knowledge of job and company policies and procedures to complete a variety of assignments

• In-depth knowledge in technical or specialty area

• Applies advanced skills to resolve complex problems independently

• May modify process to resolve situations

• Works independently within established procedures; may receive general guidance on new assignments

• May provide general guidance or technical assistance to less experienced team members

TRAINING AND WORK SCHEDULES: Your new hire training will take place 8:00am-5:00pm CST, mandatory attendance is required. 

This position is full-time (40 hours/week).  Employees are required to have flexibility to work any of our shift schedules during our normal business hours of Monday-Friday, 7:00am- 7:00pm CST.

REMOTE DETAILS: You will work remotely, full-time. It will require a dedicated, quiet, private, distraction free environment with access to high-speed internet. We will provide you with the computer, technology and equipment needed to successfully perform your job. You will be responsible for providing high-speed internet. Internet requirements include the following:

Maintain a secure, high-speed, broadband internet connection (DSL, Cable, or Fiber) at the remote location. Dial-up, satellite, WIFI, Cellular connections are NOT acceptable. Download speed of 15Mbps (megabyte per second)

• Upload speed of 5Mbps (megabyte per second