Case Coordinator

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

📋 Description

• Take complete ownership of assigned cases, overseeing the patient journey from HUB enrollment to post-fill follow-up.

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

• Provide education to patients, caregivers, and healthcare providers on topics related to reimbursement, access, and coverage.

• Perform benefits investigation and verification, including calls with payers and patients.

• Gather any missing information from Patient Enrollment Forms and validate testing, voucher, and Interim Care options.

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

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

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

• Schedule, reschedule, and confirm patient appointments and assessment tests.

• Oversee the administration of Interim Care, voucher, and copay programs, including eligibility attestations and follow-up on copay cards.

• Organize the triage of prescriptions, vouchers, paid prescriptions, and Interim Care fills within Polaris.

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

• Handle case types, documentation, texting, faxing, prescription triage, and secure communications in Polaris.

• Collaborate with HUB partners, Pfizer colleagues, Patient Support Program/HUB staff, and third-party vendors.

• Keep real-time case comments updated and manage DocuSign consents along with encrypted email communications.

• Report adverse events and adhere to company compliance, safety, confidentiality, and communication standards.

• Connect customer insights to approved resources and work collaboratively across departments to enhance patient access.

⛳️ Requirements

• A B.S. or B.A. degree is required.

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

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

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

• Capable of direct communication with patients, providers, and colleagues across various functions.

• Experience in conducting benefits investigation and verification with payers directly.

• Knowledge of prior authorization and appeals processes is essential.

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

• Ability to handle a high volume of concurrent cases with meticulous documentation and follow-through.

• Capacity to fulfill adverse event reporting responsibilities.

• 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.

• Alignment with HQ stakeholders to facilitate patient access.

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

• U.S. work visa sponsorship is currently not available and will not be in the future.

• Permanent work authorization in the United States is mandatory.

• Preferred qualifications include experience in patient/customer-facing access and reimbursement education; HUB experience; familiarity with Kite Works or similar encrypted email platforms; DocuSign; copay portal administration; coordination with third-party vendors; experience with Interim Care, free goods, or bridge programs; and knowledge of PBM and major medical benefit coverage.

• Flexibility to work across different time zones when necessary.

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

🏝️ Benefits

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

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

• 401(k) plan with Pfizer matching contributions.

• Additional contributions to Pfizer Retirement Savings.

• Paid time off for vacation, holidays, and personal days.

• Paid caregiver/parental and medical leave.

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

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