Care Coordinator

🔥 17 hours ago

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Gifthealth

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2020

🏥 Healthcare

📦 Logistics

💼 Consulting

💰 $40M Private Equity Round - GiftHealth on 2023-04

Healthcare • Logistics • Consulting

Gifthealth is a technology-enabled patient access and prescription fulfillment company that connects patients, prescribers, pharmacies, and pharmaceutical manufacturers through a unified digital platform. It streamlines enrollment, electronic benefits verification, e-prior authorization, and payment/affordability support while managing pharmacy fulfillment and patient support services. The platform also provides manufacturers with actionable data and insights on patient journeys and brand performance, driving faster, more reliable medication access.

📋 Description

• Facilitate reimbursement and access to medications for patients through payer research and HCP education and support • Engage with HCPs and their staff using a multi-channel approach to enhance experience • Support the entire reimbursement journey from patient enrollment or initiation, access determination, and payer prior authorization processes through appeals/denials requirements • Educate HCPs and office staff on available patient assistance programs • Serve as payer and pharmacy expert for a defined territory/geography and proactively communicate changes to key stakeholders • Identify market access trends from local, regional, or national payers in an assigned territory/geography • Maintain and grow knowledge of national, regional, local, and account market dynamics • Analyze an assigned territory using reporting and analytics tools • Monitor and meet program SLAs, KPIs, and other established metrics

🎯 Requirements

• Bachelor's degree or advanced degree preferred • Minimum three years' experience in the public or private third-party reimbursement arena or pharmaceutical industry in managed care, clinical support, or sales • Specialty pharmacy, hub, or patient services experience working with HCPs and payers to remove reimbursement barriers to specialty products • Strong functional knowledge of specialty pharmacy and health insurance and benefits (e.g., Medicare Part D, commercial, and Medicaid) • Knowledge of Centers for Medicare & Medicaid Services (CMS) policies and processes, with expertise in Medicare Part D (Pharmacy Benefit design and coverage policy) a plus • Knowledge of Managed Care, Government, and Federal payer sectors, as well as Integrated Delivery Networks/Integrated Health Systems, a plus • Proficiency in Microsoft Office products required, with advanced knowledge of Tableau, Excel, or other report generators, and the ability to analyze data to determine areas requiring focus • High proficiency with complex patient access CRMs (such as Salesforce.com, Veeva, or CourierHealth) • Advanced problem solving, research, and analytical skills • Advanced communication skills, both written and verbal, with required data entry accuracy • Ability to multi-task and manage time independently; client interaction experience preferred

🏖️ Benefits

• Health insurance • 401(k) matching • Flexible work hours • Paid time off • Remote work options