Care Coordinator

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

📋 Description

• Take full ownership of assigned cases and guide the patient experience from HUB enrollment through 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 regarding reimbursement, access, coverage, and program options.

• Conduct benefits investigations and verifications, including calls to payers and patients.

• Gather missing information from the Patient Enrollment Form and confirm testing, voucher, and Interim Care selections.

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

• Verify product and baseline test coverage with PBM and major medical insurance providers.

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

• Confirm and relay coverage details, costs, authorization requirements, deadlines, and baseline assessment tests.

• Organize, reschedule, and confirm patient appointments while coordinating assessment testing with vendors.

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

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

• Conduct follow-ups post-prescription at 10 and 45 days.

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

• Review prior authorization, appeal, and Patient Enrollment Form documentation for accuracy.

• Share and manage cases with HUB partners and liaise with Pfizer colleagues and external partners.

• Keep real-time case comments and document all patient and provider communications.

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

• Report adverse events while adhering to compliance, safety, confidentiality, and content-control standards.

• Collaborate across functions to enhance patient access journeys and tackle access challenges.

⛳️ Requirements

• B.S. or B.A. Degree.

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

• A minimum of 6 months as a FRM, PAC, FAS, or equivalent experience in access and reimbursement, with proficiency in 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 colleagues.

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

• Working knowledge of prior authorization and appeals processes.

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

• Capacity to manage a high volume of concurrent cases with disciplined documentation and follow-through.

• Ability to meet adverse event reporting requirements in a role with frequent direct patient interaction.

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

• Appropriate and compliant communication and collaboration with cross-functional field-based teams.

• Alignment with HQ stakeholders to facilitate patient access.

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

• Experience working in a HUB environment.

• Familiarity with Kite works or a similar encrypted email platform, DocuSign, and copay portal administration.

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

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

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

• Exceptional written and verbal communication skills.

• Strong organizational skills and attention to detail.

• Outstanding critical thinking abilities.

• Understanding of Specialty Pharmaceuticals and Patient Journeys.

• Compliance with Regulatory and Compliance Standards.

• Flexibility to work across different time zones as required.

• 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

• 401(k) plan with Pfizer Matching Contributions and an additional Pfizer Retirement Savings Contribution.

• Paid vacation, holidays, and personal days.

• Paid caregiver/parental and medical leave.

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

• 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.

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