Care Coordinator (Patient Care Navigation)

Krystal Biotech•Pittsburgh, PA

22h•Onsite

About The Position

The Care Coordinator involves coordinating and organizing various administrative tasks to ensure the smooth and efficient delivery of services to patients. The CC will ensure the output of work meets all the key performance areas within the Patient Services team and will have accountability for the timely completion of the inbound work assigned to the regional queue. The Care Coordinator will utilize Krystal Connect’s PJN (Patient Journey Navigator/SF Healthcloud platform) for all program operations and align activities regionally with the PAL (Patient Access Liaison) team. The Patient Services Department is a team-oriented group focused on collaboration with both internal and external partners with the goal of achieving positive results for patients as they begin their Vyjuvek therapy journey. Furthermore, the Patient Services team aims to pinpoint and mitigate any obstacles, specifically at the individual patient case level, to guarantee continuous accessibility to Vyjuvek. The Care Coordinator is expected to work closely with the PALs on their assigned regional caseload and facilitate the patient onboarding process. Care Coordinators are also expected to report to our Pittsburgh, PA office at least 2-3 days a week.

Requirements

BS/BA degree required in business/health-related field
Experience in coordinating services and resources, such as scheduling, record-keeping, and insurance benefit determination
Interpersonal skills to collaborate with a multidisciplinary team
Competency in administrative tasks within workflow/case management systems
Excellent written and oral communication and presentation skills
The ability to manage multiple priorities, while maintaining attention to detail is critical
Ability to prioritize tasks and resources, meet deadlines, and be flexible to changing priorities
Excellent computer skills (Microsoft Office Suite, Project, Word, Excel, PowerPoint, Outlook, and CRM platforms)

Responsibilities

Intake and processing of all inbound emails and faxes to Krystal Connect.
Qualify and assign copay cards to eligible patients for both SP and Buy/Bill patient cases.
Gather and upload approval and denial letters into PJN on the case account.
Responsible for overseeing and updating the PJN Patient therapy status, as well as tracking PA and Appeal outcomes.
Manage the follow up and resolve of cases in need of a PA reauthorization or those experiencing an insurance change with the goal to eliminate any interruptions in therapy.
Coordinate the orders for Welcome kits for each patient referral.
Coordinate the outbound faxing (Fax confirmations, PA approval notifications, PAP communications, etc.)
Collaborate with Market Access and Operations Manager in the execution of plan level
Work emails received from specialty pharmacy and/or PAL and document in PJN any updates.
Lead Case Review calls with the SP partners and PALs. Accountability and note maintenance of the cases discussed on the calls for both Pending and Active patients At Risk of therapy interruption.
Administer the PAP and TPAP programs to include the collection of required documentation and perform evaluations of patient cases for eligibility using Krystal’s eligibility rules.
Manage patient HIPAA and Marketing consents to include the coordination, collection and documentation of the consents received through the DocuSign process.
Compliance of all HIPAA Authorization requirements.
Investigation of each enrolled patient case for insurance coverage/eligibility and follow up as needed for any needed missing information.
For all Buy & Bill cases, a comprehensive benefit investigation will be conducted, encompassing Prior Auth/Appeal coordination with the HCP.
Other duties as assigned.