Care Coordinator

This is a fully remote position, open to applicants in Colorado, +5 more states.

📋 Description

• Take full ownership of assigned cases and ensure effective management of the patient journey from HUB enrollment to post-fill follow-up.

• Act as the primary point of contact for patients/caregivers and healthcare providers concerning reimbursement and access support.

• Provide education to patients, caregivers, and healthcare providers on reimbursement, access, coverage, and program requirements.

• Perform benefits investigation and verification, which includes communication with payers and patients.

• Assess product benefits, costs, deductibles, copay options, maximizers, accumulators, and reimbursement programs.

• Confirm product and baseline-test coverage with PBM and major medical insurance.

• Manage prior authorization submissions, verifications, and appeals support.

• Organize appointments, baseline assessments, patient testing, and provider confirmations.

• Oversee Interim Care, extended Interim Care, voucher, copay, and prescription-support programs.

• Process vouchers, paid prescriptions, and Interim Care fills within Polaris.

• Conduct follow-ups after prescriptions at 10 and 45 days.

• Maintain and update case records, documentation, texting, faxing, and prescription triage in Polaris.

• Collaborate and share cases with HUB partners while coordinating with Pfizer colleagues and third-party vendors.

• Keep real-time case comments and manage encrypted email and DocuSign consent processes.

• Report adverse events and adhere to company safety, compliance, content-control, and confidentiality standards.

• Work cross-functionally to enhance patient access journeys and mitigate access barriers.

⛳️ Requirements

• Bachelor of Science or Bachelor of Arts Degree.

• Over 8 years of experience in pharmaceutical or related fields in customer-facing roles/functions.

• Minimum of 6 months experience as a FRM, PAC, FAS, or similar role in access and reimbursement, with proficiency in the Polaris CRM System.

• Working knowledge of Polaris, including case management, documentation, prescription triage, and understanding PA, appeal, and PEF documentation.

• Proven ability to engage directly with patients, providers, and cross-functional colleagues.

• Experience in conducting benefit investigations and verifications directly with payers.

• Familiarity with prior authorization and appeals processes.

• Knowledge of copay programs, copay maximizers and accumulators, vouchers, and interim care programs.

• Capacity to manage a high volume of concurrent cases throughout a patient journey, averaging about 20 days.

• Ability to fulfill adverse event reporting responsibilities.

• Strong understanding of reimbursement, government payment systems, specialty pharmacy networks, co-pay assistance programs, and specialty medication.

• Effective and compliant communication and collaboration with cross-functional field-based colleagues.

• Alignment with HQ stakeholders to facilitate patient access.

• Experience in a patient and/or customer-facing role that necessitates access and reimbursement education.

• Background in working with a HUB.

• Familiarity with Kite works or similar encrypted email platforms, DocuSign, and copay portal management.

• Experience coordinating with third-party vendors for patient assessments, testing, or specialty pharmacy logistics.

• Background in supporting Interim Care, free goods, or bridge programs.

• Understanding of both pharmacy benefit (PBM) and major medical benefit coverage pathways.

• Excellent written and verbal communication abilities.

• Strong attention to detail and organizational capabilities.

• Outstanding critical thinking skills.

• Knowledge of specialty pharmaceuticals and patient journeys.

• Commitment to regulatory and compliance standards.

• Flexibility to work across different time zones if necessary.

• Candidates must be authorized to work in the U.S. by any employer.

• Permanent work authorization in the United States is mandatory.

• U.S. work visa sponsorship is not available now or in the future.

🏝️ Benefits

• Bonus target of 20.0% of base salary through Pfizer’s Global Performance Plan.

• Eligibility to participate in Pfizer’s share-based long-term incentive program.

• 401(k) plan with Pfizer matching contributions.

• Additional Pfizer retirement savings contributions.

• Paid vacation, holidays, and personal days.

• Paid caregiver/parental and medical leave.

• Medical, prescription drug, dental, and vision coverage.

• Relocation assistance may be available based on business needs and eligibility.