Sr Coordinator, Individualized Coordinator - Cardinal Health
Santa Fe, NM
About the Job
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, 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.
+ Effectively applies knowledge of job and company policies and procedures to complete a variety of assignments
+ 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 hands-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
Qualifications
+ High School diploma or equivalent, preferred
+ Previous customer service experience, preferred
+ Experience conducting and documenting patient health insurance benefit investigations, prior authorizations, and appeals, preferred (2+ years)
+ Knowledge of Medicare, Medicaid and Commercially insured payer common practices and policies, preferred
+ Critical and creative thinking, preferred
+ Knowledge of Medical/Pharmacy billing and coding, preferred
+ Strong attention to detail is vital
+ Bilingual, preferred
What is expected of you and others at this level
+ 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
TRAINING AND WORK SCHEDULES: Your new hire training will take place 8:00am-5:00pm CT, mandatory attendance is required. This position is full-time (40 hours/week). Must be available to work between the hours of 7am-7pm CT
REMOTE DETAILS: You will work remotely, full-time. It will require a dedicated, quiet, private, distraction free environment with access to high-speed internet. We will provide you with the computer, technology and equipment needed to successfully perform your job. You will be responsible for providing high-speed internet. Internet requirements include the following:
Maintain a secure, high-speed, broadband internet connection (DSL, Cable, or Fiber) at the remote location. Dial-up, satellite, WIFI, Cellular connections are NOT acceptable. Download speed of 15Mbps (megabyte per second)
+ Upload speed of 5Mbps (megabyte per second)
+ Ping Rate Maximum of 30ms (milliseconds)
+ Hardwired to the router
+ Surge protector with Network Line Protection for CAH issued equipment
Anticipated hourly range: $21.50 per hour - $30.65 per hour
Bonus eligible: No
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
Application window anticipated to close: 12/30/2024 *if interested in opportunity, please submit application as soon as possible. The hourly range listed is an estimate. Pay at Cardinal Health is determined by multiple factors including, but not limited to, a candidate’s geographical location, relevant education, experience and skills and an evaluation of internal pay equity.
_Candidates who are back-to-work, people with disabilities, without a college degree, and Veterans are encouraged to apply._
_Cardinal Health supports an inclusive workplace that values diversity of thought, experience and background. We celebrate the power of our differences to create better solutions for our customers by ensuring employees can be their authentic selves each day. Cardinal Health is an Equal_ _Opportunity/Affirmative_ _Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, ancestry, age, physical or mental disability, sex, sexual orientation, gender identity/expression, pregnancy, veteran status, marital status, creed, status with regard to public assistance, genetic status or any other status protected by federal, state or local law._
_To read and review this privacy notice click_ here (https://www.cardinalhealth.com/content/dam/corp/email/documents/corp/cardinal-health-online-application-privacy-policy.pdf)
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, 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.
+ Effectively applies knowledge of job and company policies and procedures to complete a variety of assignments
+ 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 hands-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
Qualifications
+ High School diploma or equivalent, preferred
+ Previous customer service experience, preferred
+ Experience conducting and documenting patient health insurance benefit investigations, prior authorizations, and appeals, preferred (2+ years)
+ Knowledge of Medicare, Medicaid and Commercially insured payer common practices and policies, preferred
+ Critical and creative thinking, preferred
+ Knowledge of Medical/Pharmacy billing and coding, preferred
+ Strong attention to detail is vital
+ Bilingual, preferred
What is expected of you and others at this level
+ 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
TRAINING AND WORK SCHEDULES: Your new hire training will take place 8:00am-5:00pm CT, mandatory attendance is required. This position is full-time (40 hours/week). Must be available to work between the hours of 7am-7pm CT
REMOTE DETAILS: You will work remotely, full-time. It will require a dedicated, quiet, private, distraction free environment with access to high-speed internet. We will provide you with the computer, technology and equipment needed to successfully perform your job. You will be responsible for providing high-speed internet. Internet requirements include the following:
Maintain a secure, high-speed, broadband internet connection (DSL, Cable, or Fiber) at the remote location. Dial-up, satellite, WIFI, Cellular connections are NOT acceptable. Download speed of 15Mbps (megabyte per second)
+ Upload speed of 5Mbps (megabyte per second)
+ Ping Rate Maximum of 30ms (milliseconds)
+ Hardwired to the router
+ Surge protector with Network Line Protection for CAH issued equipment
Anticipated hourly range: $21.50 per hour - $30.65 per hour
Bonus eligible: No
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
Application window anticipated to close: 12/30/2024 *if interested in opportunity, please submit application as soon as possible. The hourly range listed is an estimate. Pay at Cardinal Health is determined by multiple factors including, but not limited to, a candidate’s geographical location, relevant education, experience and skills and an evaluation of internal pay equity.
_Candidates who are back-to-work, people with disabilities, without a college degree, and Veterans are encouraged to apply._
_Cardinal Health supports an inclusive workplace that values diversity of thought, experience and background. We celebrate the power of our differences to create better solutions for our customers by ensuring employees can be their authentic selves each day. Cardinal Health is an Equal_ _Opportunity/Affirmative_ _Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, ancestry, age, physical or mental disability, sex, sexual orientation, gender identity/expression, pregnancy, veteran status, marital status, creed, status with regard to public assistance, genetic status or any other status protected by federal, state or local law._
_To read and review this privacy notice click_ here (https://www.cardinalhealth.com/content/dam/corp/email/documents/corp/cardinal-health-online-application-privacy-policy.pdf)
Source : Cardinal Health
