Case Coordinator

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

📋 Description

• Take full ownership of designated cases and guide 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, coverage, and available program options.

• Carry out benefits investigation and verification, including coverage for products and baseline tests.

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

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

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

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

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

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

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

• Conduct follow-ups on prescriptions at 10 and 45-day intervals.

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

• Collaborate and share cases with HUB partners while coordinating with Pfizer colleagues and external vendors.

• Maintain real-time comments on cases and manage patient consents through Docusign.

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

• Work collaboratively across functions to enhance patient access and resolve access barriers.

⛳️ Requirements

• B.S. or B.A. Degree.

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

• At least 6 months as a FRM, PAC, FAS, or similar position, with knowledge in access and reimbursement, and familiarity with the Polaris CRM System.

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

• Strong communication skills to interact directly with patients, providers, and cross-functional teams.

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

• Knowledgeable about prior authorization and appeals processes.

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

• Capable of managing a high volume of concurrent cases throughout an average patient journey of approximately 20 days.

• Ability to fulfill adverse event reporting responsibilities.

• In-depth understanding of Reimbursement, Government Payment Systems, Specialty Pharmacy Networks, Co-Pay Assistance Programs, and Specialty Medication.

• Communicate and collaborate compliantly with cross-functional field-based colleagues.

• Alignment with HQ stakeholders to bolster patient access.

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

• Previous experience working with a HUB.

• Familiarity with Kite works or similar encrypted email platforms, Docusign, and copay portal management.

• Experience coordinating with third-party vendors for patient assessment, testing, or specialty pharmacy logistics.

• Background supporting Interim Care, free goods, or bridge programs.

• Knowledge of both pharmacy benefit (PBM) and major medical benefit coverage pathways.

• Excellent written and verbal communication abilities.

• Strong skills in relationship-building, attention to detail, organization, critical thinking, collaboration, and networking.

• Understanding of Specialty Pharmaceuticals and the Patient Journey.

• Compliance with Regulatory and Compliance Standards.

• Flexibility to work across various time zones if necessary.

• 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.

🏝️ 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.

• Remote work from home five days a week.