Dedicated Case Coordinator

This is a fully remote position, open to applicants in Maryland, +1 more state.

📋 Description

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

• Act as the primary contact for patients, caregivers, and healthcare providers concerning reimbursement and access support.

• Provide education to patients, caregivers, and healthcare providers regarding reimbursement, access, and coverage.

• Perform benefits investigations and verifications, which include communicating with payers and patients.

• Analyze product benefits, costs, baseline appointments, deductibles, copays, maximizers, and accumulators.

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

• Validate product and baseline-test coverage across PBM and major medical insurance.

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

• Schedule, reschedule, and confirm patient appointments with patients, providers, and vendors.

• Coordinate patient assessment tests with IQVIA/MDX.

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

• Maintain access to the copay portal, assist with copay card enrollment, and ensure copay eligibility attestation.

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

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

• Manage case types, documentation, texting, faxing, prescription triage, and secure messages in Polaris.

• Collaborate and share cases with HUB partners.

• Keep real-time case comments and manage Docusign consent collection.

• Utilize Kite works encrypted email for communications with patients and providers.

• Report adverse events and adhere to company compliance, safety, confidentiality, and content-control protocols.

• Collaborate cross-functionally with internal and external colleagues to enhance patient access journeys.

⛳️ Requirements

• Bachelor's degree in a relevant field (B.S. or B.A.).

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

• Minimum of 6 months experience as a FRM, PAC, FAS, or similar role focused on access and reimbursement, specifically with Polaris CRM System.

• Proficient in Polaris, particularly in case management, documentation, prescription triage, and interpreting PA, appeal, and PEF documentation.

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

• Experience in conducting benefit investigations and verifications with payers.

• Knowledgeable in prior authorization and appeals processes.

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

• Ability to manage a high volume of concurrent cases throughout an average patient journey of approximately 20 days, with thorough documentation and follow-through.

• Capability to fulfill adverse event reporting requirements in a role involving frequent direct patient contact.

• Strong grasp of reimbursement, Government Payment Systems, Specialty Pharmacy Networks, Co-Pay Assistance Programs, and the Specialty Medication sector.

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

• Alignment with HQ stakeholders to facilitate patient access.

• Experience in a patient and/or customer-facing role requiring education on access and reimbursement.

• Familiarity working with a HUB.

• Experience with Kite works or a similar encrypted email platform, Docusign, and managing copay portals.

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

• Experience in supporting Interim Care, free goods, or bridge programs.

• Familiarity with both pharmacy benefit (PBM) and major medical benefit coverage pathways.

• Exceptional written and verbal communication skills.

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

• High attention to detail and organizational abilities.

• Excellent critical thinking skills and capacity to explain complex processes to diverse patient communities.

• Outstanding collaboration and networking skills.

• Ability to work effectively in a team environment.

• Understanding of Specialty Pharmaceuticals and Patient Journeys.

• Compliance with Regulatory and Compliance Standards.

• Flexibility to work across different time zones as required.

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

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

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

🏝️ Benefits

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

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

• 401(k) plan with matching contributions from Pfizer.

• 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.

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