Dedicated Case Coordinator

This is a fully remote position, open to applicants in Kansas, +2 more states.

📋 Description

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

• Perform benefits investigations and verifications, which may include direct communication with payers and patients.

• Acquire any missing information from the Patient Enrollment Form and verify testing, voucher, and Interim Care choices.

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

• Confirm product and baseline-test coverage through PBM and major medical insurance channels.

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

• Schedule and confirm patient appointments while coordinating baseline assessment testing with healthcare providers and vendors.

• Oversee the administration of Interim Care, extended Interim Care, voucher, and copay programs.

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

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

• Manage and update cases in Polaris utilizing texting, faxing, and prescription triage functionalities.

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

• Collaborate and share cases with HUB partners while coordinating with Pfizer colleagues and Patient Support Program/HUB staff.

• Maintain up-to-date comments on cases that document the patient journey and communication efforts.

• Utilize Kite Works encrypted email and manage the DocuSign consent procedures.

• Report any adverse events in line with company requirements.

• Communicate in a compliant manner with patients, caregivers, and healthcare providers using approved resources.

• Work collaboratively across functions to enhance the patient access journey and tackle access challenges.

• Uphold confidentiality and comply with company guidelines.

⛳️ Requirements

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

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

• At least 6 months of experience as an FRM, PAC, FAS, or similar roles, with access and reimbursement experience and familiarity with the Polaris CRM System.

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

• Ability to communicate effectively with patients, providers, and colleagues across various functions.

• Demonstrated experience in conducting benefit investigations and verifications directly with payers.

• Knowledgeable about prior authorization and appeals processes.

• Understanding of copay programs, copay maximizers and accumulators, vouchers, and interim care programs.

• Capability to manage a high volume of concurrent cases while maintaining disciplined documentation and follow-through.

• Ability to adhere to adverse event reporting requirements.

• Strong grasp of Reimbursement, Government Payment Systems, Specialty Pharmacy Networks, Co-Pay Assistance Programs, and Specialty Medications.

• Communicate and collaborate appropriately and compliantly with field-based colleagues and HQ stakeholders.

• Experience in a patient- and/or customer-facing role that involves access and reimbursement education (preferred).

• Familiarity with working in a HUB environment (preferred).

• Experience with Kite Works or similar encrypted email platforms, DocuSign, and administration of copay portals (preferred).

• Background in coordinating with third-party vendors for patient assessments, testing, or specialty pharmacy logistics (preferred).

• Experience supporting Interim Care, free goods, or bridge programs (preferred).

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

• Exceptional written and verbal communication capabilities.

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

• Excellent attention to detail and organizational abilities.

• Outstanding critical thinking skills.

• Ability to comprehend complex processes and convey information effectively to diverse patient communities.

• Strong collaboration and networking skills.

• Capacity to work effectively in a team setting.

• Knowledge of Specialty Pharmaceuticals and Patient Journeys.

• Commitment to regulatory and compliance standards.

• Flexibility to operate across various time zones, if necessary.

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

• Must be legally authorized to work in the U.S. for any employer.

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

• Permanent work authorization in the United States is required.

🏝️ Benefits

• Target bonus of 20.0% through Pfizer’s Global Performance Plan.

• Participation in a share-based long-term incentive program.

• 401(k) plan with Pfizer Matching Contributions.

• Additional retirement savings contributions from Pfizer.

• Paid vacation, holidays, and personal days.

• Paid caregiver/parental and medical leave.

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

• Potential relocation assistance based on business needs and/or eligibility.