Sr. Coordinator, Individualized Care (Case Manager)
About The Position
Cardinal Health Sonexus™ Access and Patient Support helps specialty pharmaceutical manufacturers remove barriers to care so that patients can access, afford and remain on the therapy they need for a better quality of life. Our diverse expertise in pharma, payer and hub services allows us to deliver best-in-class solutions—driving brand and patient markers of success. We’re continuously integrating advanced and emerging technologies to streamline patient onboarding, qualification and adherence. Our non-commercial specialty pharmacy is centralized at our custom-designed facility outside of Dallas, Texas, empowering manufacturers to rethink the reach and impact of their products. What Individualized Care contributes to Cardinal Health 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. Responsibilities The Case Manager supports patient access to therapy through Reimbursement Support Services in accordance with the program business rules and HIPAA regulations. This position is responsible for guiding the patient through the various process steps of their patient journey to therapy. These steps include patient referral intake, investigating all patient health insurance benefits (pharmacy and medical benefits), and proactively following up with various partners including the insurance payers, specialty pharmacies, support organizations, and the patient/physician to facilitate coverage and delivery of product in a timely manner.
Requirements
- 3-6 years of experience preferred
- High School Diploma, GED or technical certification in related field or equivalent experience, preferred
- Effectively applies knowledge of job and company policies and procedures to complete a variety of assignments
- In-depth knowledge in technical or specialty area
- Applies advanced skills to resolve complex problems independently
- May modify process to resolve situations
- Works independently within established procedures; may receive general guidance on new assignments
- May provide general guidance or technical assistance to less experienced team members
Responsibilities
- Investigate and resolve patient/physician inquiries and concerns in a timely manner
- Mediate 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
- Demonstrate superior customer support talents
- Prioritize multiple, concurrent assignments and work with a sense of urgency
- Must communicate clearly and effectively in both a written and verbal format
- Must demonstrate a superior willingness to help external and internal customers
- Working alongside teammates to best support the needs of the patient population or will transfer caller to appropriate team member (when applicable)
- Maintain accurate and detailed notations for every interaction using the appropriate database for the inquiry
- Must self-audit intake activities to ensure accuracy and efficiency for the program
- Make outbound calls to patient and/or provider to discuss any missing information as applicable
- Assess patient’s financial ability to afford therapy and provide hand on guidance to appropriate financial assistance
- Documentation must be clear and accurate and stored in the appropriate sections of the database
- Must track any payer/plan issues and report any changes, updates, or trends to management
- Handle escalations and ensure proper communication of the resolution within required timeframe agreed upon by the client
- Ability to effectively mediate situations in which parties are in disagreement to facilitate a positive outcome
- Concurrently handle multiple outstanding issues and ensure all items are resolved in a timely manner to the satisfaction of all parties
- Support team with call overflow and intake when needed
- Proactively following up with various partners including the insurance payers, specialty pharmacies, support organizations, and the patient/physician to facilitate coverage and delivery of product in a timely manner.
Benefits
- Cardinal Health offers a wide variety of benefits and programs to support health and well-being.
- Medical, dental and vision coverage
- Paid time off plan
- Health savings account (HSA)
- 401k savings plan
- Access to wages before pay day with myFlexPay
- Flexible spending accounts (FSAs)
- Short- and long-term disability coverage
- Work-Life resources
- Paid parental leave
- Healthy lifestyle programs
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
