Case Manager / Patient Advocate (non-clinical)

PharmaCord • Jeffersonville, IN

210d • Hybrid

About The Position

When you join the team as the Case Manager / Patient Advocate (non-clinical), you'll have the opportunity to make a difference in the lives of our patients each day as they look to you as part of their dedicated support team for helping them navigate the tricky process to getting access to their complex medication. You'll compassionately deliver an exceptional experience to many patients per day always remembering that every prescription or document belongs to a real person who is looking for thorough and efficient management of their records. You'll adjust your approach to their needs by communicating clearly, focusing on the accuracy of the details of their medical records and your mastery of the program requirements, and ensuring their prescriptions or cases are handled timely. The Case Manager / Patient Advocate (non-clinical) role may be eligible for a hybrid schedule after 6 months (or sooner once proficiency in role is demonstrated). A typical day in the Case Manager / Patient Advocate (non-clinical) role will include ownership of your patients cases from initiation to closure to include; benefit investigations, prior authorizations / denial appeals, determining financial qualifications for assistance programs and assisting patients or other callers/stakeholders through resolution (via email, inbound/outbound calls and using our patented technology, Lynk) by using your critical thinking skills and your knowledge of the program and industry rules and standards. This role requires a high level of ownership, attention to detail and patient focus and will put your problem-solving skills to the test!

Requirements

• Bachelor's degree strongly preferred or equivalent experience required
• Customer service and healthcare industry experience is preferred but not required
• Ability to work an 8.5-hour shift between 8 am to 9 pm, Monday to Friday required
• Bi-lingual skills in Spanish and English are a plus

Responsibilities

• Builds trusted relationships with patients, prescribers, client stakeholders through proactive communication, timely and accurate execution of deliverables and demonstrated relentless passion for helping patients
• Performs program welcome calls to patients
• Performs post Benefits Investigation calls to patients and physicians explaining coverage options
• Manages all client inquiries unable to be determined by client through reporting
• Manages HCP inquiries, as applicable, pursuant to business rules
• Manages inbound calls as directed by the program-approved FAQs
• Triage patients to internal or external resources as appropriate
• Provides personalized case management to patients and HCPs including outbound communication to HCPs and patients to communicate benefit coverage and next steps in obtaining coverage
• Leverages electronic tools to identify benefits and payer coverage; completes manual benefit investigation as needed
• Identifies and communicates patient's plan benefit coverage including the need for prior authorization, appeal, tier exception, and/or formulary exclusions
• Uses electronic resources to obtain benefit coverage outcome and if needed, outbound call to payers and HCPs to follow up on proper submission and/or outcome
• Coordinates nurse teach with field-based nurse educators, as applicable to program
• Supports adherence services through coordination of nurse follow up, as applicable to program
• Identifies peer support resources for patients
• Coordinates shipment of product through patient assistance program and/or bridge program from the PharmaCord pharmacy
• Proactively communicates needs for reverification of prior authorization or re-enrollment for patient assistance program
• Reports adverse events, Product complaints, special situation reports and/or medical inquiries received in accordance with SOPs and the Business Rules
• Documents all activities within the PharmaCord Lynk system in accordance with business requirements

Benefits

• Company paid Short-term Disability (STD)
• Increased competitive 401(k) company match up to 4%
• Affordable Medical, Dental, and Vision benefits - PharmaCord covers 75% of Medical Premiums for our employees
• Wellness discounts of up to $260 per year for participation in wellness program
• Annual HSA employer contribution
• Company paid and voluntary Life Insurance options
• Voluntary Life, AD&D and Long-Term Disability Insurances
• Paid Parental Leave of Absence
• Wellness and Employee Assistance Programs
• PTO benefits, flex days and paid holidays
• Employee Referral Program
• Ambassador Program
• Tuition reimbursement program up to $5,000 per year
• Competitive starting pay rates
• Toll reimbursement program (valued at $678.60 per year)
• This role may be eligible for a remote working arrangement, subject to all work from home criteria met and based on business need
• Multiple shift options between 8 AM and 9 PM Monday - Friday

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Professional, Scientific, and Technical Services
• Education Level: Bachelor's degree
• Number of Employees: 1,001-5,000 employees