Case Manager

When you join the team as the Case Manager, you'll have the opportunity to make a difference in the lives of our patients each day as they look to you as part of their dedicated support team for helping them navigate the tricky process to getting access to their complex medication. You'll compassionately deliver an exceptional experience to many patients per day always remembering that every prescription or document belongs to a real person who is looking for thorough and efficient management of their records. You'll adjust your approach to their needs by communicating clearly, focusing on the accuracy of the details of their medical records and your mastery of the program requirements, and ensuring their prescriptions or cases are handled timely. This role may be eligible for a hybrid schedule after 6 months (or sooner once proficiency in role is demonstrated). Review our Benefits & Perks below to learn more

Check below to see if you have what is needed for this opportunity, and if so, make an application asap.

A typical day in this role will include ownership of your patients cases from initiation to closure to include; benefit investigations, prior authorizations / denial appeals, determining financial qualifications for assistance programs and assisting patients or other callers/stakeholders through resolution (via email, inbound/outbound calls and using our patented technology, Lynk) by using your critical thinking skills and your knowledge of the program and industry rules and standards. This role requires a high level of ownership, attention to detail and patient focus and will put your problem-solving skills to the test

A typical day in the life of a Case Manager will include the following:
The responsibilities include, but are not limited to the following:
Relationship Management
Builds trusted relationships with patients, prescribers, client stakeholders through proactive communication, timely and accurate execution of deliverables and demonstrated relentless passion for helping patients
Manages all relationships in a manner that adheres to healthcare laws and regulations
Communications
Performs program welcome calls to patients
Performs post Benefits Investigation calls to patients and physicians explaining coverage options
Manages all client inquiries unable to be determined by client through reporting
Manages HCP inquiries, as applicable, pursuant to business rules
Inbound Call Management
Manages inbound calls as directed by the program-approved FAQs
Triage patients to internal or external resources as appropriate
Personalized Case Management
Provides personalized case management to patients and HCPs including outbound communication to HCPs and patients to communicate benefit coverage and next steps in obtaining coverage
Leverages electronic tools to identify benefits and payer coverage; completes manual benefit investigation as needed
Identifies and communicates patient’s plan benefit coverage including the need for prior authorization, appeal, tier exception, and/or formulary exclusions
Uses electronic resources to obtain benefit coverage outcome and if needed, outbound call to payers and HCPs to follow up on proper submission and/or outcome
Coordinates nurse teach with field-based nurse educators, as applicable to program
Supports adherence services through coordination of nurse follow up, as applicable to program
Identifies peer support resources for patients
Coordinates shipment of product through patient assistance program and/or bridge program from the PharmaCord pharmacy
Proactively communicates needs for reverification of prior authorization or re-enrollment for patient assistance program
Reports adverse events, Product complaints, special situation reports and/or medical inquiries received in accordance with SOPs and the Business Rules
Documents all activities within the PharmaCord Lynk system in accordance with business requirements
This job might be for you if (must have requirements of the role):
Successful candidates possess the following personal attributes:
Detail oriented
Professional telephone etiquette
Self-awareness of your own emotions and the potential impact on others
Basic computer knowledge
Ability to multitask effectively
Ability to recognize emotions and their effects
Sureness about self-worth and capabilities
Manage disruptive impulses
Maintain standards of honesty and integrity
Takes responsibility for performance
Adapts and handles change with flexibility
Is innovative and open to new ideas
Achievement driven; constant striving to improve or to meet a standard of excellence
Aligns with the goals of the group or organization
Ready to take initiative and act on opportunities
Be optimistic and pursue goals persistently despite obstacles and setbacks
Be service oriented and anticipate, recognize and meet needs of others, including patients and care partners
Clear and concise communication
Positive attitude
Requirements:
Bachelor’s degree strongly preferred
Customer service and healthcare industry experience is preferred but not required
Ability to work an 8.5-hour shift between 8 am to 11 pm, Monday to Friday required
Bi-lingual in English and Spanish or Chinese/Mandarin is a plus
This is an office-based position, the ability to sit for extended periods of time is necessary
Although very minimal, flexibility to travel as needed is preferred
All employees working onsite in a PharmaCord facility are strongly encouraged to be vaccinated against COVID-19
We are located in Jeffersonville, IN. You must be willing to work in this location; PharmaCord does reimburse for tolls if applicable, at the frequent user rate. This rate is applied after 40 trips per month (valued at $678.60 per year)
Physical Demands & Work Environment:
While performing the duties of this job, the employee is regularly required to talk or hear. The employee is frequently required to sit for long periods of time, use hands to type, handle or feel; and reach with hands and arms. Must be able to type 35 WPM with 97% accuracy.
Although very minimal, flexibility to travel as needed is preferred.
This position requires ability to work a standard 8.5-hour standard shifts between our business operating hours of 8am - 11pm Monday through Friday. A shift will be assigned and may change depending on business need.
This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, etc.
Due to investment in program specific training, candidates are expected to maintain role for a minimum of 6 months, or within a client-facing role, prior to being considered eligible for lateral or promotion level move. PharmaCord is committed to creating a strong company culture that values collaboration, employee development, and promotion from within. Exceptions will be reviewed on a case-by-case basis to assess business need and service impact.
Once you land this position, you’ll get to enjoy:
Our Benefits & Perks
Company paid Short-term Disability (STD)
Increased competitive 401(k) company match up to 4%
Affordable Medical, Dental, and Vision benefits - PharmaCord covers 75% of Medical Premiums for our employees
PharmaCord has not increased healthcare premiums in the past 4 years
Concierge Medical Clinic free of cost for those enrolled in a PharmaCord medical plan (including dependents)
Wellness discounts of up to $260 per year for participation in wellness program
Annual HSA employer contribution
Company paid and voluntary Life Insurance options
Voluntary Life, AD&D and Long-Term Disability Insurances
Paid Parental Leave of Absence
Wellness and Employee Assistance Programs
PTO benefits, flex days and paid holidays
Employee Referral Program
Ambassador Program
Tuition reimbursement program up to $5,000 per year
Competitive Compensation & Flexible Working
Competitive starting pay rates
Yearly merit increases
Toll reimbursement program (valued at $678.60 per year)
This role may be eligible for a hybrid schedule (50% in office, 50% remote). To qualify for a hybrid schedule, you are required to work a minimum of 6 months on-site at our headquarters location. You must show you've successfully completed training, are in good performance and attendance standing, and are consistently meeting KPI's as outlined within the program business rules.
Multiple shift options between 8 AM and 11 PM Monday - Friday
A Career You'll Love
Working for PharmaCord - voted Best Places to Work in Kentucky for 2019 and 2021
Work for a company that values diversity and makes deliberate efforts to create in inclusive workplace
Opportunities for advancement with a company that supports personal and professional growth
A challenging, stimulating work environment that encourages new ideas
Exposure to many learning and development opportunities
Playing a crucial part in the lives of our patients, physicians, and pharmacies by enhancing the patient services experience
Our new state of the art Headquarters building offering many amenities including collaborations spaces, outdoor dining, walking path, marketplace café, and more
Any offer of employment is contingent on completion of a background check to company standard. Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

At PharmaCord, we don’t just accept difference – we celebrate it, support it and we thrive on it for the benefit of our employees, our products and our community. PharmaCord is proud to be an equal opportunity employer.

In order to maintain a safe workplace for our team members, PharmaCord strongly recommends that all employees are vaccinated against COVID-19. PharmaCord is unable to sponsor employees at this time.

Want to learn more about us? Find us on LinkedIn, Glassdoor, Twitter & Facebook

---