Case Coordinator

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

📋 Description

• Take full responsibility for assigned cases and oversee the patient journey from HUB enrollment 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 about reimbursement, access, coverage, and patient access requirements.

• Facilitate discussions on Summary of Benefits and gather any missing information from the Patient Enrollment Form.

• Analyze out-of-pocket expenses, deductibles, copayment options, reimbursement programs, maximizers, and accumulators.

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

• Manage prior authorization submissions, verification, appeals support, and compliance with deadlines.

• Conduct benefit investigations and verification calls with payers and patients.

• Organize, reschedule, and confirm patient appointments and initial assessments.

• Coordinate patient assessment tests with IQVIA/MDX and third-party vendors.

• Oversee Interim Care, extended Interim Care, voucher, free-goods, and copayment programs.

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

• Maintain access to the copay portal and assist eligible patients in acquiring copay cards.

• Follow up with patients 10 and 45 days post-prescription to resolve any logistical or financial inquiries.

• Administer cases and documentation within Polaris, including texting, faxing, prescription triage, and case comments.

• Collaborate with HUB partners and coordinate with Pfizer colleagues and Patient Support Program/HUB staff.

• Utilize Kite Works encrypted email and DocuSign for communication and obtaining necessary consents.

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

• Collaborate cross-functionally to enhance the patient access journey and tackle access barriers.

⛳️ Requirements

• Bachelor’s degree (B.S. or B.A.).

• 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, specifically with the Polaris CRM System.

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

• Proven capability to communicate effectively with patients, providers, and cross-functional colleagues.

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

• Knowledge of prior authorization and appeals processes.

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

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

• Ability to fulfill adverse event reporting requirements in a role involving frequent direct patient interaction.

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

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

• Exceptional written and verbal communication abilities.

• Strong relationship-building, critical-thinking, attention to detail, organizational, collaborative, and networking skills.

• Comprehension of specialty pharmaceuticals and patient journeys.

• Commitment to regulatory and compliance standards.

• Willingness to work across various time zones if necessary.

• Availability to travel approximately 10% to 20%.

• Candidates must have authorization to work in the U.S. by any employer.

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

• Permanent work authorization in the United States is required.

🏝️ Benefits

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

• Paid vacation, holidays, and personal days.

• Paid caregiver/parental leave and medical leave.

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

• Participation in Pfizer’s Global Performance Plan with a bonus target of 20.0% of base salary.

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

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

• Remote work from home 5 days a week for remote colleagues.