Executive Case Manager

4 days ago


Jeffersonville, Indiana, United States PharmaCord Full time
Job Summary

PharmaCord is seeking an experienced Executive Case Manager to join our team. As an Executive Case Manager, you will play a critical role in ensuring that patients receive timely and efficient access to their medications. You will work closely with patients, healthcare providers, and payers to resolve reimbursement and access issues.

Key Responsibilities
  • Manage patient cases from initiation to closure, utilizing critical thinking skills and knowledge of program requirements.
  • Complete benefit investigations, track prior authorizations and denial appeals, and assist patients and stakeholders through resolution.
  • Provide education on insurance coverage and common access and reimbursement challenges affecting patients, healthcare providers, and clients.
  • Leverage electronic tools to identify benefits and payer coverage, and complete manual benefit investigations as needed.
  • Serve as a subject matter expert to internal teams, providing expertise on insurance coverage and access and reimbursement challenges.
Requirements
  • Completion of a Bachelor's degree (or higher) in a related field, such as healthcare administration or social science.
  • Two years of experience in insurance reimbursement, patient access, direct patient care, and/or patient education.
  • Strong understanding of medical terminology, coding systems, and insurance processes.
  • Excellent attention to detail and organizational skills.
  • Ability to prioritize tasks and work efficiently in a fast-paced environment.
  • Effective written and verbal communication and interpersonal skills.
  • Demonstrated ability to think critically and issue resolve.
  • Knowledge of healthcare compliance regulations, including HIPAA and Medicare/Medicaid guidelines.
What We Offer
  • Competitive salary and benefits package.
  • Opportunity to work in a dynamic and growing company.
  • Support for professional development and growth.


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