नोकरीचे वर्णन

Position Overview

We are recruiting a Care Coordinator to facilitate patient access and reimbursement for medications by supporting healthcare provider (HCP) education, payer research, and patient services. This role ensures seamless alignment with organizational compliance standards and operational goals, supporting assigned territories or accounts. The Care Coordinator acts as a liaison to reimbursement and assistance programs to enable therapy access.

Primary Responsibilities

Engage with healthcare providers and staff through various communication channels to support reimbursement inquiries utilizing approved resources.
Oversee the reimbursement process from patient enrollment and access determinations through prior authorizations, appeals, and denial situations.
Educate HCPs and office personnel about patient assistance programs and their importance for eligible therapy access.
Act as an expert on payers and pharmacies within a defined geographic area, maintaining proactive communication with internal and external stakeholders.
Analyze payer trends at multiple levels and collaborate with internal and client teams to facilitate patient access and support pull-through initiatives.
Maintain comprehensive knowledge of market dynamics including coverage and authorization requirements.
Utilize reporting and analytics to inform territory support, strategic decisions, and to identify critical focus areas.
Monitor and meet service level agreements, key performance indicators, and other benchmarks.
Adapt quickly to changes in policies, markets, and account complexities while managing multiple stakeholders and patient needs.
Expand expertise in hub and specialty pharmacy channels to better support HCP offices and patients.
Collaborate across teams sharing insights on customer needs, barriers, and payer challenges.
Work closely with client Reimbursement Access Managers to support territorial and HCP accounts.
Identify and communicate key customer insights through effective inquiry and analytical thinking.
Conduct all activities in accordance with legal, ethical, and compliance standards of the client.

Qualifications

Education: Bachelor’s degree required, advanced degree preferred.
Experience: At least three years in third-party reimbursement, managed care, clinical support, or pharmaceutical sales.
Expertise in specialty pharmacy, hub services, patient assistance, and removing reimbursement barriers within specialty products.
Strong understanding of health insurance, including Medicare Part D, commercial insurance, Medicaid, eligibility verification, prior authorization, reimbursement, financial assistance, co-pay support, and bridge programs.
Familiarity with CMS policies and Medicare Part D pharmacy benefit design is an advantage.
Knowledge of managed care, government, federal payer sectors, and integrated health systems is beneficial.
Proficiency in Microsoft Office and advanced skills in Tableau, Excel, or other analytic/reporting tools.
Experience with complex patient access CRMs like Salesforce.com, Veeva, or CourierHealth and adept at multitasking across systems.
Strong problem-solving, research, analytical, and communication skills both verbal and written.
Ability to manage multiple tasks, work independently, and interact with clients effectively.

Desired Personal Attributes

Collaborative team player working effectively with internal and external stakeholders.
Patient and provider service-oriented mindset with excellent customer service skills; call center experience preferred.
High attention to detail and urgency in task execution.
Willingness to support team goals and assist fellow Patient Access Managers.

Work Environment and Conditions

Remote, field-based role covering assigned geography or accounts.
Full-time schedule: 40 hours per week, Monday to Friday aligned with program hours.
Occasional weekend and holiday work depending on HCP or client needs; limited travel under 10%.
Regular collaboration meetings with patient services, client Access Managers, and other stakeholders.
Must maintain reliable remote connectivity and efficiently use multiple CRM and reporting systems with precision.
Customer-facing responsibilities requiring interaction with various levels of clinical, patient, and client staff.

Employment Details and Legal Compliance

Status: Full-time, non-exempt classification.
Equal opportunity employer committed to non-discriminatory hiring and employment practices.
Job duties and descriptions may be modified as needed by the employer.

Compensation

The role offers an hourly wage range of $24 to $29.

Care Coordinator