Sr. Coordinator, Individualized Care (Case Manager)

Cardinal Health

4d•$21 - $31•Remote

About The Position

Delivering an exclusive model that fully integrates direct drug distribution to site-of-care with non-commercial pharmacy services, patient access support, and financial programs, Sonexus Health, a subsidiary of Cardinal Health, helps specialty pharmaceutical manufacturers have a greater connection to the customer experience and better control of product success. Personalized service and creative solutions executed through a flexible technology platform means providers are more confident in prescribing drugs, patients can more quickly obtain and complete therapy, and manufacturers can directly access more actionable insight than ever before. With all services centralized in our custom-designed facility outside of Dallas, Texas, Sonexus Health helps manufacturers rethink how far their products can go.

Requirements

High School Diploma, GED, or equivalent work experience.
Must demonstrate efficiency and strong organizational skill.
Must demonstrate superior customer support talents that remain in compliance with standard call quality expectations.
Must communicate clearly and effectively in both a written and verbal format.
Must meet the daily task and benefit investigation goals associated with a high enrollment volume/low patient interaction program.
Strong attention to detail.

Nice To Haves

3-6 years experience in related field preferred.
1-2 years experience conducting and documenting patient health insurance benefit investigations, prior authorizations, and appeals, preferred.
Knowledge of Medicare, Medicaid and Commercially insured payer common practices and policies, preferred.
Critical and creative thinking, preferred.
Knowledge of the Health Insurance Market Place and the Affordable Care Act preferred.
Knowledge of Medical/Pharmacy billing and coding is preferred.

Responsibilities

Supports patient access to therapy through Reimbursement Support Services in accordance with the program business rules and HIPAA regulations.
Guides healthcare providers through the various process steps in support of their patient’s journey to therapy.
Investigates all patient health insurance benefits.
Initiates prior authorization and step therapy reviews.
Proactively follows up with various partners including the insurance payers, specialty pharmacies, and support organizations to facilitate coverage and delivery of product in a timely manner.
Mediates effective resolution for complex payer/pharmacy issues toward a positive outcome to de-escalate.
Proactive follow-up with various contacts to ensure patient access to therapy.
Handles inbound & outbound call interactions, demonstrating superior customer support talents that remain in compliance with standard call quality expectations.
Communicates clearly and effectively in both a written and verbal format.
Meets the daily task and benefit investigation goals associated with a high enrollment volume/low patient interaction program.