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

The Case Manager supports patient access to therapy through Reimbursement Support Services in accordance with the program business rules and HIPAA regulations. This position is responsible for guiding the patient through the various process steps of their patient journey to therapy. These steps include patient referral intake, investigating all patient health insurance benefits (pharmacy and medical benefits), and proactively following up with various partners including the insurance payers, specialty pharmacies, support organizations, and the patient/physician to facilitate coverage and delivery of product in a timely manner.

• First point of contact handling inbound calls, with ability to determine needs and provide one call resolution
• Process enrollments via inbound fax, phone, and electronically.
• Provide world-class service and receive inbound calls from patients, healthcare provider offices, SPs, and customers, striving for one-call resolution.
• Mediate effective resolution for complex payer/pharmacy issues toward a positive outcome to de-escalate
• Must meet the daily task and benefit investigation goals associated with a high enrollment volume/low patient interaction program.
• Investigate and resolve patient/physician inquiries and concerns in a timely manner
• Proactive follow-up with various contacts to ensure patient access to therapy
• Demonstrate superior customer support talents
• Prioritize multiple, concurrent assignments and work with a sense of urgency
• Must communicate clearly and effectively in both a written and verbal format
• Must demonstrate a superior willingness to help external and internal customers
• Working alongside teammates to best support the needs of the patient population or will transfer caller to appropriate team member (when applicable)
• Maintain accurate and detailed notations for every interaction using the appropriate database for the inquiry
• Must self-audit intake activities to ensure accuracy and efficiency for the program
• Make outbound calls to patient and/or provider to discuss any missing information as applicable
• Assess patient’s financial ability to afford therapy and provide hand on guidance to appropriate financial assistance
• Documentation must be clear and accurate and stored in the appropriate sections of the database
• Must track any payer/plan issues and report any changes, updates, or trends to management
• Handle escalations and ensure proper communication of the resolution within required timeframe agreed upon by the client
• Ability to effectively mediate situations in which parties are in disagreement to facilitate a positive outcome
• Concurrently handle multiple outstanding issues and ensure all items are resolved in a timely manner to the satisfaction of all parties
• Investigate and resolve patient/physician inquiries and concerns in a timely manner
• Enter detailed information into company proprietary software while conversing via telephone
• Place outbound phone calls for patient follow ups or confirmations
• Proactively following up with various partners including the insurance payers, specialty pharmacies, support organizations, and the patient/physician to facilitate coverage and delivery of product in a timely manner.
• Conducting initial assessments to understand patient /HCP needs and gather information to determine eligibility
• Evaluating client needs and making appropriate referrals to relevant programs or services. 
• Collaborate with both internal and external teams, focusing on problem-solving and teamwork.
• Cultivate innovation by consistently monitoring systems,