Case Coordinator

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

📋 Description

• Take full ownership of assigned cases, guiding the patient journey from HUB enrollment through 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 reimbursement, access, and coverage processes.

• Conduct investigations and verifications of benefits, including product and baseline test coverage.

• Review Summary of Benefits, product benefit structures, associated costs, and appointments for baseline testing.

• Collect any missing information from Patient Enrollment Forms and verify details regarding testing, vouchers, and Interim Care options.

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

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

• Perform benefit investigation and verification calls with payers and patients.

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

• Collaborate with IQVIA/MDX and other vendors on patient assessments and testing requirements.

• Oversee Interim Care program requirements, deadlines, and Extended Interim Care programs.

• Confirm voucher eligibility and manage voucher shipments.

• Maintain access to the copay portal, assist patients in securing copay cards, and handle copay eligibility attestations.

• Follow up post-fill at 10 and 45 days to address any logistical or financial inquiries.

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

• Update and manage case types in Polaris utilizing texting, faxing, and prescription triage capabilities.

• Review prior authorization, appeal, and PEF documentation for precision and accuracy.

• Collaborate with HUB partners to share and manage cases throughout patient journeys.

• Coordinate with Pfizer colleagues and Patient Support Program/HUB employees to resolve patient case issues.

• Maintain real-time comments on cases, including notes from every interaction with healthcare providers and patients.

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

• Report adverse events in accordance with company protocols.

• Communicate access options and approved resources in a compliant manner.

• Work collaboratively across internal and external teams to enhance patient access.

• Build trust through compliant follow-ups and thorough knowledge of the access journey.

• Travel approximately 10% to 20% as necessary.

⛳️ Requirements

• B.S. or B.A. degree.

• At least 8 years of experience in the pharmaceutical industry (or a related field) in customer-facing roles/functions.

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

• Working knowledge of Polaris, including case management, documentation, prescription triage, and understanding of prior authorization, appeal, and PEF documentation.

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

• Experience conducting benefit investigations and verifications directly with payers.

• Familiarity with prior authorization and appeals processes.

• Knowledgeable about copay programs, maximizers and accumulators, vouchers, and free or interim care programs.

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

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

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

• Compliant communication and collaboration with cross-functional field-based colleagues.

• Alignment with HQ stakeholders to facilitate patient access.

• Experience in patient and/or customer-facing roles that require education on access and reimbursement.

• Background in working with a HUB.

• Familiarity with Kite works or similar encrypted email platforms, 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 pharmacy benefit (PBM) and major medical benefit coverage pathways.

• Excellent written and verbal communication skills.

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

• Strong attention to detail and organizational skills.

• Exceptional critical thinking abilities and the capacity to convey complex processes to diverse patient communities.

• Understanding of specialty pharmaceuticals and patient journeys.

• Commitment to adhering to regulatory and compliance standards.

• Willingness to work across different time zones as needed.

• Ability to travel approximately 10% to 20%.

• Candidates must be authorized to work in the U.S. by any employer.

• Permanent work authorization in the United States is required.

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

🏝️ Benefits

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

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

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

• Paid vacation, holiday, and personal days.

• Paid caregiver/parental and medical leave.

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

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