Case Coordinator

Job not on LinkedIn

🔥 3 hours ago

🌲 North Carolina, South Carolina – Remote

🌲 North Carolina – Remote 🌴 South Carolina – 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 patient 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 and baseline-test coverage • Review Summary of Benefits, out-of-pocket costs, deductibles, copay options, maximizers, accumulators, and reimbursement programs • Obtain missing Patient Enrollment Form information and verify testing, voucher, and Interim Care selections • Oversee prior authorization submissions, verification, appeals support, and deadlines • Conduct benefit investigation and verification calls with payers and patients • Schedule, reschedule, and confirm patient appointments and baseline assessments • Coordinate patient assessment testing with IQVIA/MDX and other vendors • Manage Interim Care program administration, including Extended Interim Care programs • Confirm voucher eligibility and triage vouchers for shipment • Maintain copay portal access, help eligible patients obtain copay cards, and manage copay eligibility attestations • Triage voucher, paid prescription, and Interim Care fills within Polaris • Follow up with patients 10 and 45 days after prescription to resolve logistical or financial questions • Manage and update cases in Polaris using texting, faxing, and prescription triage capabilities • Review prior authorization, appeal, and Patient Enrollment Form documentation • Share and manage cases with HUB partners and coordinate with Pfizer colleagues and Patient Support Program/HUB employees • Maintain real-time case comments documenting every patient and HCP call • Use Kite Works encrypted email and manage DocuSign consent processes • Report adverse events in accordance with company requirements • Communicate compliantly using Brand RC-approved materials and follow company compliance guidelines • Collaborate cross-functionally to improve the patient access journey and address access barriers • Build trust through compliant follow-up and knowledge of the access journey

🎯 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 and HQ stakeholders • Experience in a patient and/or customer-facing role requiring access and reimbursement education (nice-to-have) • Experience working with a HUB (nice-to-have) • Experience with Kite works or comparable encrypted email platform, Docusign, and copay portal administration (nice-to-have) • Experience coordinating with third-party vendors on patient assessment, testing, or specialty pharmacy logistics (nice-to-have) • Experience supporting Interim Care, free goods, or bridge programs (nice-to-have) • Experience with both pharmacy benefit (PBM) and major medical benefit coverage pathways (nice-to-have) • Excellent written and verbal communication skills • Exceptional relationship-building, critical-thinking, organizational, and collaboration skills • 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 required; U.S. work visa sponsorship is not available now or in the future

🏖️ Benefits

• 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 • 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 • Relocation assistance may be available based on business needs and/or eligibility