Sr. Coordinator, Patient Access (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:

• Receive inbound and outbound calls from patients, healthcare provider offices, SPs, and customers, striving for one-call resolution

• Manage the entire care process with a sense of urgency from benefit investigation/verification to medication delivery, ensuring an exceptional patient experience

• Conduct benefit verifications and collaborate with various healthcare providers, including physicians, specialty pharmacies, and insurance companies, to ensure seamless coordination of patient care and timely access to necessary services

• Assist in obtaining insurance, prior authorization, and appeal requirements and outcomes

• Help patients understand their insurance plan coverage, including out-of-pocket costs, and provide guidance on the appeals process if needed

• Resolve patient's questions and any representative for the patient’s concerns regarding status of their request for assistance

• Demonstrate expertise in payer landscapes and insurance processes. Remain knowledgeable about long and short-range changes in the reimbursement environment including Medicare, Medicaid, Managed Care, and Commercial medical and pharmacy plans while planning for various scenarios that may impact prescribed products

• Process enrollments via fax, phone, and electronically as needed

• Scrutinize forms and supporting documentation thoroughly for any missing information or new information to be added to the database 

Qualifications:

• 2-4 years of industry experience with patient-facing or high touch customer interaction experience preferred

• Previous Hub or Patient Support Service experience preferred

• High School diploma or equivalent preferred

• Knowledge of Medicare (A, B, C, D), Medicaid & Commercial payers policies and guidelines for coverage, preferred

• Strong people skills that demonstrate flexibility, persistence, creativity, empathy, and trust.   

• Robust computer literacy skills including data entry and MS Office-based software programs 

• Strong understanding of pharmaceutical therapies, disease states, and medication adherence challenges preferred

• Excellent written and oral communication, mediation, and problem-solving skills, including the ability to connect with patients, caregivers, and providers
   

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- 8:00pm 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 spee