Case Coordinator

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

📋 Description

• Take full ownership of assigned cases and oversee 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 options.

• Carry out benefits investigation and verification, including interactions with payers and patients.

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

• Confirm product and baseline test coverage across Pharmacy Benefit Managers (PBM) and major medical insurance.

• Oversee prior authorization and appeals processes.

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

• Manage Interim Care, extended Interim Care, vouchers, and copay programs.

• Triage prescriptions and fills within the Polaris system.

• Conduct follow-up with patients post-prescription at 10 and 45 days.

• Maintain case records, documentation, communication via text and fax, and prescription triage in Polaris.

• Share and manage cases in collaboration with HUB partners.

• Coordinate efforts with Pfizer colleagues, Patient Support Program/HUB personnel, and external vendors.

• Keep real-time comments on cases and manage patient consents using Docusign.

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

• Comply with communication of access options and utilize Brand RC-approved materials.

• Collaborate cross-functionally to enhance the patient access journey and tackle access barriers.

⛳️ Requirements

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

• Over 8 years of experience in the pharmaceutical industry (or related fields) in customer-facing roles/functions.

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

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

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

• 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 free or interim care programs.

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

• Capability to meet reporting obligations for adverse events.

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

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

• Alignment with HQ stakeholders to facilitate patient access.

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

• Permanent work authorization in the United States is mandatory.

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

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

• Flexibility to work across different time zones as needed.

🏝️ Benefits

• 401(k) plan with Pfizer matching contributions, plus an additional Pfizer retirement savings contribution.

• Paid vacation, holidays, and personal days.

• Paid caregiver/parental and medical leave.

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

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

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

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

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