Patient Care Coordinator, Specialty - Evernorth

The Cigna Group

11h•Remote

About The Position

The Patient Care Coordinator is responsible for the timely intake and processing of all incoming cases, acting as a key liaison between patients, caregivers, medical providers, and internal teams. This role ensures accurate coordination of patient deliveries, monitors cases for proper escalation, and performs select activities related to clinical management and refill setup for specialty patients under the supervision of a licensed pharmacist. Responsibilities include completing prescription intake, creating and maintaining patient accounts, and utilizing electronic methods to send and receive information from medical professionals. As part of Evernorth Health Services, this role supports CarepathRx within our Pharmacy and Care Delivery organization, focusing on specialty pharmacy and infusion services in partnership with hospitals and health systems. The Cigna Group is dedicated to improving the health and vitality of those they serve through Cigna Healthcare and Evernorth Health Services, committed to enhancing the lives of clients, customers, and patients.

Requirements

Strong customer service and interpersonal skills with a focus on client satisfaction.
Excellent written and verbal communication skills.
Ability to manage time efficiently, remain organized, and work independently or in a team environment.
Maintains confidentiality when handling patient information.
Demonstrates initiative by presenting ideas and suggestions to management.
Maintains professionalism and service orientation in all interactions.
Proficient in Microsoft Suite and familiar with business applications.
Ability to follow through and complete tasks on schedule while meeting quality standards.
High School Diploma or GED required
2 years+ of experience in customer service or claims
Proficiency in English spoken and written
Strong research, planning, and coordination skills.
Ability to build relationships across teams and work effectively in a matrix environment.
Independent problem-solving skills with sound judgment; ability to escalate issues when necessary.
If working at home occasionally or permanently, internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

Nice To Haves

Pharmacy Technician certification preferred.
Prior specialty healthcare experience is a plus.

Responsibilities

Serve as the primary point of contact between medical providers, insured individuals, and internal teams, primarily via phone and email.
Gather and verify necessary information to facilitate case processing and patient care coordination.
Complete prescription intake and maintain accurate patient accounts and medication profiles under pharmacist supervision.
Review and monitor cases, escalating to appropriate teams based on identified triggers.
Ensure compliance with established workflows, process documentation, and regulatory requirements.
Coordinate patient deliveries by communicating with patients, caregivers, and medical staff.
Make outbound and receive inbound calls to/from patients, caregivers, and medical staff; conduct follow-up calls as directed by a licensed pharmacist.
Provide support to specialty pharmacy team, including prescription order setup, refill requests, and processing.
Maintain accurate documentation in patient medical records and work proficiently in work queues.
Provide excellent internal and external customer service, maintaining a professional and service-oriented approach.
Act as a conduit of information between specialty pharmacy, operations, and patients, caregivers, or medical professionals.
Complete assigned daily/weekly tasks accurately and on schedule.
Perform other duties/tasks as required and assigned.