Sr. Coordinator, Individualized Care
Job Description
Job Description Summary
Cardinal Health Sonexus™ Access and Patient Support helps specialty pharmaceutical manufacturers remove barriers to care so that patients can access, afford and remain on the therapy they need for a better quality of life. Our diverse expertise in pharma, payer and hub services allows us to deliver best-in-class solutions—driving brand and patient markers of success. We’re continuously integrating advanced and emerging technologies to streamline patient onboarding, qualification and adherence. Our non-commercial specialty pharmacy is centralized at our custom-designed facility outside of Dallas, Texas, empowering manufacturers to rethink the reach and impact of their products.
Job Description
What Individualized Care contributes to Cardinal Health
Delivering an exclusive model that fully integrates direct drug distribution to site-of-care with non-commercial pharmacy services, patient access support, and financial programs, Sonexus Health, a subsidiary of Cardinal Health , helps specialty pharmaceutical manufacturers have a greater connection to the customer experience and better control of product success. Personalized service and creative solutions executed through a flexible technology platform means providers are more confident in prescribing drugs, patients can more quickly obtain and complete therapy, and manufacturers can directly access more actionable insight than ever before. With all services centralized in our custom-designed facility outside of Dallas, Texas, Sonexus Health helps manufacturers rethink how far their products can go.
What is expected of you and others at this level
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Applies acquired job skills and company policies and procedures to complete standard tasks
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Works on routine assignments that require basic problem resolution
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Refers to policies and past practices for guidance
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Receives general direction on standard work; receives detailed instruction on new assignments
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Refers to policies and past practices for guidance
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Receives general direction on standard work; receives detailed instruction on new assignments
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Consults with supervisor or senior peers on complex and unusual problems
Accountabilities
The Case Manager supports patient access to therapy through Reimbursement Support Services in accordance with the program business rules and HIPAA regulations. This position is responsible for guiding the healthcare providers through the various process steps in support of their patient’s journey to therapy. These steps include patient referral intake, investigating all patient health insurance benefits, identifying & initiating prior authorization and step therapy reviews, proactively following up with various partners including the insurance payers, specialty pharmacies, and support organizations to facilitate coverage and delivery of product in a timely manner.
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Must demonstrate efficiency and strong organizational skill
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Mediate effective resolution for complex payer/pharmacy issues toward a positive outcome to de-escalate
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Proactive follow-up with various contacts to ensure patient access to therapy
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Call interactions are inbound & outbound: Must demonstrate superior customer support talents that remain in compliance with standard call quality expectations.
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Must communicate clearly and effectively in both a written and verbal format
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Must meet the daily task and benefit investigation goals associated with a high enrollment volume/low patient interaction program.
Qualifications
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High School Diploma, GED, or equivalent work experience
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3-6 years experience in related field preferred
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1-2 years experience conducting and documenting patient health insurance benefit investigations, prior authorizations, and appeals, preferred
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Knowledge of Medicare, Medicaid and Commercially insured payer common practices and policies, preferred
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Critical and creative thinking, preferred