Dedicated Case Coordinator Great Lakes

Pfizer • USA - MI - Remote, MI

22h • $162,900 - $271,500 • Remote

About The Position

The Inflammation and Immunology Dedicated Case Coordinator (DCC) is a non-promotional, field-based role that supports patients’ access to PDPA and VFM products when prescribed by a licensed healthcare provider. The DCC owns the continual management and progression of the patient journey — from HUB enrollment through post-fill follow-up — working directly with patients, providers, payers, HUB partners, and third-party vendors. It is a dual patient- and HCP-facing role spanning a patient journey, and the colleague in this role carries 100% ownership of every case in their assigned geography.

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, with providers, and with cross-functional colleagues
• Experience conducting benefit investigation and verification directly with payers, and 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 that could average 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 knowledge of the Specialty Medication area.
• Appropriate and compliant communication and collaboration with cross-functional field-based colleagues (Sales, Medical, FRM, PCA/SAS, KAD, Government Relations) to ensure optimal and appropriate patient access in both in-patient and out-patient accounts.
• Alignment with HQ stakeholders to ensure appropriate understanding of, and support for patient access (e.g., Brand and Customer Marketing teams and PCA/SAS teams).
• Candidates must be authorized to be employed in the U.S. by any employer.
• U.S. work visa sponsorship (such as TN, O-1, H-1B, etc.) is not available for this role now or in the future.

Nice To Haves

• Experience in a Patient and/or customer facing role requiring access and reimbursement education.
• Experience working with a HUB.
• Experience with Kite works or a comparable encrypted email platform, Docusign, and copay portal administration
• Experience coordinating with third-party vendors on patient assessment, testing, or specialty pharmacy logistics (e.g., IQVIA/MDX, Sonexus)
• Experience supporting Interim Care, free goods, or bridge programs
• Experience with both pharmacy benefit (PBM) and major medical benefit coverage pathways
• Excellent communication skills, both written and verbal
• Exceptional relationship building skills, especially with elderly age groups
• Trust
• Integrity
• Empathy
• Patience
• Deliver meaningful & concise presentations
• Strong attention to detail and organizational skills
• Exceptional critical thinking skills, ability to understand complex processes and effectively communicate to diverse community 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

Responsibilities

• Own 100% of assigned cases and drive the continual management and progression of the patient journey, from HUB enrollment through post-fill follow-up
• Be the central point-of-contact for patients/caregivers and HCP providers regarding the status of their request for reimbursement and access support related to a patient case.
• Answer questions from patients/caregivers relating to access and coverage
• Maintain a clear understanding of the patient access journey and requirements at each stage of the process, as well as the role played by patients/caregivers and HCP providers in the process
• Support access with HCPs and opted-in patients/caregivers who have been prescribed a PDPA OR VFM product
• Conduct the Summary of Benefits (SOB) discussion required for every HUB-enrolled patient, reviewing both the product benefit structure, any associated cost and the baseline appointments for VFM
• Obtain all missing information on the Patient Enrollment Form (PEF) and verify the testing, voucher, and Interim Care options selected by the HCP office
• Walk the patient through out-of-pocket cost, deductibles, copay options, and the reimbursement program, including the impact of maximizers and accumulators
• Verify coverage for the product and for required baseline tests across both PBM and major medical insurance for VFM
• Oversee the entire prior authorization process, including submission and verification with both the patient and the provider
• Conduct benefit investigation and verification (BI/BV) calls directly with payers and patients for patients with 3rd party restrictions
• Confirm and communicate product coverage, cost, prior authorization and appeal requirements, Interim Care program PA and Appeal deadlines, and baseline assessment tests to HCP and patient
• Schedule, reschedule and confirm patient appointments in coordination with the patient, the provider, and the vendor
• Secure the appropriate confirmation communication back from the provider (CFT)
• Coordinate compliantly with IQVIA/MDX on patient assessment tests — confirm tests are completed and reschedule where needed
• Once IC is approved, manage all Interim Care (IC) program administrative requirements and deadlines with the provider and the patient, including Extended Interim Care programs
• Confirm voucher need and eligibility with the provider and patient, and triage the voucher for shipment to the patient
• Maintain Copay portal access and help approved commercial patients secure a copay card
• Own copay eligibility attestation responsibility
• Follow up with the patient post-fill to confirm the copay card is functioning correctly
• Triage the voucher, paid prescription, and/or Interim Care fill within Polaris
• Contact the patient at 10 days and again at 45 days post-prescription, confirming that no logistical or financial questions remain outstanding
• Manage and update various case types in Polaris, using its texting, faxing, and prescription triage capabilities
• View and interpret prior authorization, appeal, and PEF documentation for accuracy
• Share and manage cases with HUB partners across all patient journeys
• Coordinate as appropriate with other Pfizer colleagues and Patient Support Program/HUB employees, via tasks and secure messages to requests for action, to help resolve problems with individual patient cases
• Maintain case comments as a real-time account of the patient journey, including a recap of every call made to the HCP and the patient
• Use the Kite works encrypted email system for correspondence with patients and providers
• Manage the Docusign process with patients to obtain required consents
• Develop an organized, concise, and compliant way to manage assigned patient cases within established time frames
• Report adverse events (AEs) in accordance with company requirements — AE reporting volume is elevated in this role, patient contact is more frequent and spans the entire patient journey
• Operate within the tighter content controls and system permissions that apply to this role
• Compliantly communicate the access landscape and options to patients/caregivers and HCPs
• Link the patient access support to meet patient needs, using Brand RC-approved materials
• Conduct yourself with the utmost discretion and confidentiality
• Adhere to strict company compliance guidelines and procedures
• Work and lead cross-functionally with internal and external colleagues, compliantly, to improve the patient access journey
• Effectively link customer insights to the offerings and approved resources to address patient access barriers
• Build trust through compliant follow-up and knowledge of the access journey
• Demonstrate excellence in responsible business communication, both written and spoken

Benefits

• 401(k) plan with Pfizer Matching Contributions
• additional Pfizer Retirement Savings Contribution
• paid vacation
• holiday and personal days
• paid caregiver/parental and medical leave
• health benefits to include medical, prescription drug, dental and vision coverage

What This Job Offers

• Job Type: Full-time
• Career Level: Senior