Case Coordinator

Job not on LinkedIn

🔥 3 minutes ago

🌽 Illinois – Remote

🌽 Illinois – Remote

💵 $162.9k - $271.5k / year

⏰ Full Time

🟠 Senior

🔴 Lead

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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Pfizer

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1849

💼 Consulting

📣 Marketing

💊 Pharmaceuticals

💰 Post-IPO Debt on 2023-05

Consulting • Marketing • Pharmaceuticals

Pfizer is a pharmaceutical company that has been at the forefront of scientific innovation for 175 years. The company is dedicated to improving health and well-being at every stage of life by providing access to safe, effective, and affordable medicines and healthcare services. Pfizer focuses on delivering innovative therapies, particularly in the field of cancer treatments, as it continues to progress in transforming the healthcare landscape.

📋 Description

• Own 100% of assigned cases and continually manage and progress the patient journey from HUB enrollment through post-fill follow-up • Serve as the central point of contact for patients/caregivers and healthcare providers regarding reimbursement and access support • Answer patient/caregiver questions about access and coverage • Support access for HCPs and opted-in patients/caregivers prescribed PDPA or VFM products • Conduct Summary of Benefits discussions for HUB-enrolled patients • Obtain missing Patient Enrollment Form information and verify testing, voucher, and Interim Care options • Explain out-of-pocket costs, deductibles, copay options, reimbursement programs, maximizers, and accumulators • Verify product and baseline-test coverage across PBM and major medical insurance for VFM • Oversee prior authorization submissions, verification, and appeals support • Conduct benefit investigation and verification calls with payers and patients • Communicate coverage, cost, prior authorization, appeal requirements, deadlines, and baseline assessment tests • Schedule, reschedule, and confirm patient appointments with patients, providers, and vendors • Coordinate patient assessment testing with IQVIA/MDX • Manage Interim Care program requirements and deadlines • Confirm voucher eligibility and triage vouchers for shipment • Maintain copay portal access, help patients secure copay cards, and own eligibility attestations • Follow up post-fill to confirm copay card functionality • Triage voucher, paid prescription, and Interim Care fills within Polaris • Contact patients 10 and 45 days after prescription to resolve logistical or financial questions • Manage case types in Polaris using texting, faxing, and prescription triage capabilities • Review prior authorization, appeal, and PEF documentation for accuracy • Share and manage cases with HUB partners • Coordinate with Pfizer colleagues and Patient Support Program/HUB employees to resolve patient-case issues • Maintain real-time case comments documenting every HCP and patient call • Use Kiteworks encrypted email and manage DocuSign consents • Report adverse events according to company requirements • Communicate access options compliantly using Brand RC-approved materials • Maintain discretion and confidentiality and adhere to compliance procedures • Work cross-functionally to improve the patient access journey and address access barriers

🎯 Requirements

• B.S. or B.A. Degree • 8+ years of pharmaceutical (or related) experience in customer-facing roles/functions • 6 months minimum as a FRM, PAC, FAS or similar experience in access and Reimbursement and working with Polaris CRM System • Working proficiency in Polaris, including case management and documentation, prescription triage, and interpretation of PA, appeal, and PEF documentation • Demonstrated ability to communicate directly with patients, providers, and cross-functional colleagues • Experience conducting benefit investigation and verification directly with payers • Working knowledge of prior authorization and appeals processes • Working knowledge of copay programs, copay maximizers and accumulators, vouchers, and free or interim care programs • Ability to own a high volume of concurrent cases across a patient journey averaging approximately 20 days, with disciplined documentation and follow-through • Ability to meet adverse event reporting obligations in a role with frequent, direct patient contact • Strong understanding of Reimbursement, Government Payment Systems, Specialty Pharmacy Networks, Co-Pay Assistance Programs, and Specialty Medication • Appropriate and compliant communication and collaboration with cross-functional field-based colleagues • Alignment with HQ stakeholders to support patient access • Candidates must be authorized to be employed in the U.S. by any employer • U.S. work visa sponsorship is not available now or in the future • Position requires permanent work authorization in the United States • Ability to travel approximately 10% to 20% • Flexibility to work across different time zones if needed • Nice-to-have: patient/customer-facing access and reimbursement education experience • Nice-to-have: experience working with a HUB • Nice-to-have: Kiteworks or comparable encrypted email platform, DocuSign, and copay portal administration • Nice-to-have: coordinating with third-party vendors on patient assessment, testing, or specialty pharmacy logistics • Nice-to-have: supporting Interim Care, free goods, or bridge programs • Nice-to-have: pharmacy benefit (PBM) and major medical benefit coverage experience • Excellent written and verbal communication skills • Strong attention to detail and organizational skills • Exceptional critical thinking skills • Understanding of Specialty Pharmaceuticals and Patient Journeys • Adherence to Regulatory and Compliance Standards

🏖️ Benefits

• 401(k) plan with Pfizer Matching Contributions • Additional Pfizer Retirement Savings Contribution • Paid vacation, holiday and personal days • Paid caregiver/parental and medical leave • Medical, prescription drug, dental and vision coverage • Bonus target of 20.0% of base salary through Pfizer’s Global Performance Plan • Eligibility to participate in Pfizer’s share based long term incentive program • Relocation assistance may be available based on business needs and/or eligibility