Case Coordinator

Job not on LinkedIn

🔥 3 minutes ago

🤠 Texas – Remote

🤠 Texas – 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 drive 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 • Educate patients, caregivers, and healthcare providers on reimbursement, access, and coverage • Conduct benefits investigation and verification, including product coverage and baseline test coverage • Review Summary of Benefits, product benefit structure, associated costs, and baseline appointments • 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 • Oversee prior authorization submissions, verification, appeals support, and related deadlines • Conduct benefit investigation and verification calls with payers and patients • Schedule, reschedule, and confirm patient appointments and assessment tests • Coordinate with IQVIA/MDX and other vendors on patient assessments and testing • Manage Interim Care program requirements, deadlines, and Extended Interim Care programs • Confirm voucher eligibility and triage vouchers for shipment • Maintain copay portal access, help patients secure copay cards, and own copay eligibility attestations • Follow up post-fill at 10 and 45 days to resolve logistical or financial questions • Triage vouchers, paid prescriptions, and Interim Care fills within Polaris • Manage and update 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 across patient journeys • Coordinate with Pfizer colleagues and Patient Support Program/HUB employees to resolve patient-case issues • Maintain real-time case comments, including every call with healthcare providers and patients • Use Kite works encrypted email and manage DocuSign consent processes • Report adverse events according to company requirements • Compliantly communicate access options and approved resources • Work cross-functionally with internal and external colleagues to improve patient access • Build trust through compliant follow-up and knowledge of the access journey • Travel approximately 10% to 20% as required

🎯 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 the Specialty Medication area • Compliant communication and collaboration with cross-functional field-based colleagues • Alignment with HQ stakeholders to support patient access • Experience in a patient and/or customer-facing role requiring access and reimbursement education • Experience working with a HUB • Experience with Kite works or comparable encrypted email platform, Docusign, and copay portal administration • Experience coordinating with third-party vendors on patient assessment, testing, or specialty pharmacy logistics • Experience supporting Interim Care, free goods, or bridge programs • Experience with pharmacy benefit (PBM) and major medical benefit coverage pathways • Excellent written and verbal communication skills • Exceptional relationship-building skills, especially with elderly age groups • Strong attention to detail and organizational skills • Exceptional critical thinking skills and ability to communicate complex processes to diverse patient communities • Understanding of Specialty Pharmaceuticals and Patient Journeys • Adherence to regulatory and compliance standards • Flexibility to work across different time zones if needed • Ability to travel approximately 10% to 20% • Candidates must be authorized to be employed in the U.S. by any employer • Permanent work authorization in the United States is required • U.S. work visa sponsorship is not available now or in the future

🏖️ Benefits

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