Case Coordinator

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

📋 Description

• Take full ownership of assigned cases and lead 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 about reimbursement, access, and coverage.

• Conduct discussions on Summary of Benefits and gather any missing Patient Enrollment Form information.

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

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

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

• Carry out benefit investigation and verification calls with payers and patients.

• Organize and coordinate patient appointments, baseline assessments, testing, and rescheduling.

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

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

• Perform 10-day and 45-day follow-ups after prescriptions are filled.

• Handle case types, documentation, texting, faxing, prescription triage, and secure messaging within Polaris.

• Collaborate with HUB partners and coordinate with Pfizer colleagues, HUB employees, and third-party vendors.

• Maintain real-time case comments and manage encrypted emails and DocuSign consents.

• Report adverse events and adhere to company requirements, content controls, and system permissions.

• Communicate access options in a compliant manner using approved materials.

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

⛳️ Requirements

• Bachelor’s Degree (B.S. or B.A.).

• Minimum of 8 years of experience in customer-facing roles/functions within the pharmaceutical or related industry.

• At least 6 months of experience as a FRM, PAC, FAS, or in a comparable role focused on access and reimbursement while using the Polaris CRM System.

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

• Proven ability to communicate effectively with patients, providers, and cross-functional team members.

• 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.

• Capability to manage a high volume of concurrent cases throughout the patient journey, with rigorous documentation and follow-through.

• Ability to fulfill adverse event reporting obligations in a role with frequent direct patient interaction.

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

• Conduct communication and collaboration with cross-functional field-based colleagues in a compliant manner.

• Align with HQ stakeholders to support patient access initiatives.

• Permanent work authorization in the United States is required.

• Preferred: Experience in patient/customer-facing access and reimbursement education, working with a HUB, Kite Works or similar encrypted email systems, DocuSign, copay portal management, third-party vendors, interim care/free goods/bridge programs, and PBM and major medical benefit coverage pathways.

• Excellent written and verbal communication abilities.

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

• High attention to detail and exceptional organizational skills.

• Critical thinking skills with the ability to explain complex processes to diverse patient communities.

• Strong collaboration and networking abilities.

• Understanding of specialty pharmaceuticals and patient journeys.

• Commitment to adhering to regulatory and compliance standards.

• Flexibility to work across different time zones as required.

🏝️ 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, holiday, 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/or eligibility.