Case Coordinator

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

📋 Description

• Take full ownership of assigned cases and effectively manage the patient journey from HUB enrollment to post-fill follow-up.

• Act as the primary 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 investigations and verifications, including discussions on Summary of Benefits and making payer calls.

• Collect missing information from Patient Enrollment Forms and confirm testing, voucher, and Interim Care selections.

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

• Confirm coverage for products and baseline tests with both PBM and major medical insurance providers.

• Manage prior authorization submissions, verifications, appeals support, and ensure compliance with related deadlines.

• Organize and schedule patient appointments, baseline assessments, testing, and vendor communications.

• Oversee the administration of Interim Care, extended Interim Care, vouchers, copay cards, and copay eligibility attestations.

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

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

• Supervise various case types, documentation, secure messaging, texting, faxing, and prescription triage in Polaris.

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

• Maintain up-to-date case comments and manage encrypted emails and DocuSign consent processes.

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

• Work collaboratively across functions to enhance the patient access experience and tackle access obstacles.

⛳️ Requirements

• Bachelor of Science (B.S.) or Bachelor of Arts (B.A.) degree.

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

• At least 6 months of experience as a FRM, PAC, FAS, or in a similar role focused on access and reimbursement, with familiarity with the Polaris CRM system.

• Proficiency in Polaris, encompassing case management, documentation, prescription triage, and understanding of PA, appeal, and PEF documentation.

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

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

• Solid understanding of prior authorization and appeals processes.

• Knowledge of copay programs, copay maximizers and accumulators, vouchers, and free or interim care initiatives.

• Capacity to manage a significant volume of concurrent cases throughout a patient journey averaging around 20 days.

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

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

• Ensure appropriate and compliant communication and collaboration with cross-functional field-based colleagues.

• Alignment with HQ stakeholders to bolster patient access.

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

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

• Permanent work authorization in the United States is required for this position.

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

• Flexibility to work across various time zones if necessary.

🏝️ Benefits

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

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

• 401(k) plan with Pfizer matching contributions.

• Additional contributions to Pfizer Retirement Savings.

• Paid vacation, holidays, and personal days.

• Paid caregiver/parental leave and medical leave.

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

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

• Opportunity for remote work from home 5 days a week.