Care Coordinator

This is a fully remote position, open to applicants in Florida.

📋 Description

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

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

• Provide education to patients, caregivers, and healthcare providers regarding reimbursement, access, and coverage.

• Perform benefits investigations and verifications, including discussions of Summary of Benefits.

• Collect missing information from Patient Enrollment Forms and confirm testing, voucher, and Interim Care selections.

• Clarify out-of-pocket expenses, deductibles, copay options, reimbursement programs, maximizers, and accumulators.

• Verify product and baseline-test coverage across PBM and major medical insurance plans.

• Oversee submissions for prior authorization, verifications, appeals support, and associated deadlines.

• Coordinate appointments, baseline assessments, testing, confirmations, and rescheduling with providers and vendors.

• Manage Interim Care, extended Interim Care, voucher, and copay programs.

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

• Reach out to patients at 10 and 45 days post-prescription to address logistical or financial inquiries.

• Manage and update cases in Polaris utilizing texting, faxing, and prescription-triage functionalities.

• Review prior authorization, appeal, and Patient Enrollment Form documents for correctness.

• Collaborate and manage cases with HUB partners while coordinating with Pfizer colleagues and Patient Support Program/HUB staff.

• Maintain real-time comments on cases documenting patient journeys and calls.

• Utilize Kite works encrypted email and oversee DocuSign consent processes.

• Report adverse events in compliance with company policies.

• Ensure compliant communication using Brand RC-approved materials and company guidelines.

• Work collaboratively with internal and external colleagues to enhance the patient access journey.

• Connect customer insights to authorized resources that address patient access challenges.

• Build trust through compliant follow-up and a deep understanding of the access journey.

⛳️ Requirements

• B.S. or B.A. Degree.

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

• Bilingual proficiency in English and Spanish; ability to communicate effectively in both languages, both verbally and in writing.

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

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

• Proven ability to communicate directly with patients, providers, and cross-functional teams.

• Experience conducting benefit investigations and verifications directly with payers.

• Knowledge of prior authorization and appeals processes.

• Familiarity with copay programs, copay maximizers and accumulators, vouchers, and free or interim care programs.

• Ability to manage a high volume of concurrent cases throughout a patient journey averaging approximately 20 days, with disciplined documentation and follow-through.

• Capability to meet adverse event reporting obligations in a role with frequent, direct patient interaction.

• Strong understanding of Reimbursement, Government Payment Systems, Specialty Pharmacy Networks, Co-Pay Assistance Programs, and Specialty Medication.

• Appropriate, compliant communication and collaboration with cross-functional field-based colleagues and HQ stakeholders.

• Experience in a patient and/or customer-facing role that involves access and reimbursement education (preferred).

• Experience working with a HUB (preferred).

• Familiarity with Kite works or similar encrypted email platforms, DocuSign, and copay portal administration (preferred).

• Experience coordinating with third-party vendors on patient assessment, testing, or specialty pharmacy logistics (preferred).

• Experience supporting Interim Care, free goods, or bridge programs (preferred).

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

• Excellent written and verbal communication skills.

• Exceptional relationship-building skills, particularly with elderly populations.

• Strong attention to detail and organizational abilities.

• Exceptional critical thinking skills and the ability to comprehend complex processes, communicating them to diverse patient communities.

• Ability to collaborate effectively within a team environment.

• Understanding of Specialty Pharmaceuticals and Patient Journeys.

• Commitment to Regulatory and Compliance Standards.

• Flexibility to work across different time zones if necessary.

• Willingness to travel approximately 10% to 20% of the time.

• Must be legally authorized to work in the U.S. for any employer; permanent work authorization in the United States is required.

• U.S. work visa sponsorship is currently not available, nor will it be 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 Contribution.

• Paid vacation, holidays, and personal days.

• Paid caregiver/parental leave and medical leave.

• Comprehensive medical, prescription drug, dental, and vision coverage.

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