Dedicated Case Coordinator

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

📋 Description

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

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

• Address questions from patients and caregivers about access and coverage.

• Facilitate access for healthcare providers and enrolled patients or caregivers prescribed PDPA or VFM products.

• Conduct discussions on Summary of Benefits and review product benefits, costs, and baseline appointments.

• Gather missing information from Patient Enrollment Forms and verify selections for testing, vouchers, and Interim Care.

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

• Verify coverage for products and baseline tests across PBM and major medical insurance for VFM.

• Oversee prior authorization submissions, verification processes, and appeals support.

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

• Communicate requirements for coverage, costs, authorizations, appeals, Interim Care, and baseline assessments.

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

• Coordinate patient assessment testing with IQVIA/MDX.

• Manage the administration of the Interim Care program, including deadlines and Extended Interim Care programs.

• Confirm voucher eligibility and manage voucher shipments.

• Maintain access to the copay portal, assist patients in securing copay cards, and manage copay eligibility attestations.

• Follow up post-fill to ensure the functionality of copay cards.

• Manage voucher, paid prescription, and Interim Care fills within Polaris.

• Contact patients 10 and 45 days post-prescription to address logistical or financial queries.

• Manage and update case types in Polaris using texting, faxing, and prescription triage capabilities.

• Review prior authorization, appeal, and PEF documentation for accuracy.

• Share and manage cases collaboratively with HUB partners.

• Coordinate with Pfizer colleagues, Patient Support Program/HUB staff, and third-party vendors to resolve case issues.

• Maintain real-time case comments, including summaries of every HCP and patient interaction.

• Utilize Kite Works for encrypted email and manage DocuSign consents.

• Report adverse events in compliance with company requirements.

• Communicate access options and patient support in a compliant manner using approved materials.

• Uphold discretion, confidentiality, and adherence to company guidelines.

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

⛳️ Requirements

• Bachelor of Science or Bachelor of Arts 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 role, with experience in access and reimbursement, and familiarity with the Polaris CRM System.

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

• Proven ability to communicate directly with patients, providers, and colleagues across functions.

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

• Knowledge of prior authorization and appeals processes.

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

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

• Ability to fulfill adverse event reporting obligations in a role involving frequent direct patient contact.

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

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

• Alignment with HQ stakeholders to support patient access initiatives.

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

• Familiarity with working at a HUB (preferred).

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

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

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

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

• 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 patient journeys.

• Adherence to regulatory and compliance standards.

• Flexibility to work across different time zones as needed.

• Willingness to travel approximately 10% to 20%.

• Candidates must have authorization to be employed in the U.S. by any employer.

• Permanent work authorization in the United States is required; U.S. work visa sponsorship is not available now or in the future.

🏝️ 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, holidays, and personal days.

• Paid caregiver/parental and medical leave.

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

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

• Remote work from home 5 days a week for remote colleagues.