Case Coordinator

Job not on LinkedIn

🔥 3 hours ago

🇺🇸 United States – 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 manage 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 Summary of Benefits discussions for every HUB-enrolled patient • Obtain missing Patient Enrollment Form information and verify testing, voucher, and Interim Care selections • 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 • Oversee prior authorization submissions, verification, and appeals support • Conduct benefit investigation and verification calls with payers and patients • Communicate coverage, cost, authorization, appeal, Interim Care, and baseline-assessment requirements • Schedule, reschedule, and confirm patient appointments • Coordinate patient assessment tests with IQVIA/MDX • Manage Interim Care program requirements, deadlines, and extended programs • Confirm voucher eligibility and triage vouchers for shipment • Maintain copay portal access, help patients secure copay cards, and manage eligibility attestations • Follow up post-fill to confirm copay card functionality • Triage vouchers, paid prescriptions, and Interim Care fills in Polaris • Contact patients 10 and 45 days post-prescription • Manage case types and documentation in Polaris, including texting, faxing, and prescription triage • Review prior authorization, appeal, and PEF documentation for accuracy • Share and manage cases with HUB partners • Coordinate with Pfizer colleagues, Patient Support Program/HUB employees, and external partners • Maintain real-time case comments and call recaps • Use Kite works encrypted email and manage DocuSign consents • Report adverse events according to company requirements • Communicate access options compliantly using Brand RC-approved materials • Maintain confidentiality and follow company compliance procedures • Collaborate cross-functionally to improve the patient access journey • Connect customer insights to approved resources addressing patient 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 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 • 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 skills, especially with elderly age groups • Strong attention to detail and organizational skills • Exceptional critical thinking skills • Ability to understand complex processes and communicate effectively to diverse communities of patients • Outstanding collaboration and networking abilities • Ability to work in a team environment • Understanding of Specialty Pharmaceuticals and Patient Journeys • Adherence to Regulatory and Compliance Standards • Flexibility to work across different time zones if needed • 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 • Ability to travel approximately 10% to 20%

🏖️ Benefits

• Global Performance Plan bonus target of 20.0% of base salary • 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