Sr. Coordinator, Individualized Care (Case Manager)

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. Responsibilities First point of contact on inbound calls and determines needs and handles accordingly Creates and completes accurate applications for enrollment with a sense of urgency Scrutinizes forms and supporting documentation thoroughly for any missing information or new information to be added to the database Conducts outbound correspondence when necessary to help support the needs of the patient and/or program Resolves patient questions and any representative for the patient’s concerns regarding status of their request for assistance Updates internal treatment plan statuses and external pharmacy treatment statuses Maintains accurate and detailed notations for every interaction using the appropriate database for the inquiry Self‑audit intake activities to ensure accuracy and efficiency for the program Makes all outbound calls to patient and/or provider to discuss any missing information and/or benefit related information Notifies patients, physicians, practitioners, and/or clinics of any financial responsibility of services provided as applicable Assesses patient’s financial ability to afford therapy and provides hand‑on guidance to appropriate financial assistance Follows through on all benefit investigation rejections, including Prior Authorizations, Appeals, etc. All avenues to obtain coverage for the product must be fully exhausted Tracks any payer/plan issues and reports any changes, updates, or trends to management Searches insurance options and explains various programs to the patient while helping them to select the best coverage option for their situation Handles all escalations based upon region and ensures proper communication of the resolution within required time frame agreed upon by the client Serves as a liaison between client sales force and applicable party Mediate situations in which parties are in disagreement and facilitates a positive outcome Concurrently handles multiple outstanding issues and ensures all items are resolved in a timely manner to the satisfaction of all parties Is responsible for reporting any payer issues by region with the appropriate team As needed conducts research associated with issues regarding the payer, physician’s office, and pharmacy to resolve issues swiftly Qualifications Previous customer service experience is preferred High School diploma or equivalent preferred Patient Support Service experience, preferred Clear knowledge of Medicare (A, B, C, D), Medicaid & Commercial payers policies and guidelines for coverage, preferred Knowledge of DME, MAC practices if preferred Clear understanding of Medical, Supplemental, and pharmacy insurance benefit practices, preferred 1‑2 years of Pharmacy and/or Medical Claims billing and Coding work experience 1‑2 years experience with Prior Authorization and Appeal submissions Ability to work with high volume production teams with an emphasis on quality Intermediate to advanced computer skills and proficiency in Microsoft Office including but not limited to Word, Outlook and preferred Excel capabilities Previous medical experience is preferred Adaptable and Flexible, preferred Self‑Motivated and Dependable, preferred Strong ability to problem solve, preferred Bilingual is preferred What is expected of you and others at this level Effectively applies knowledge of job and company policies and procedures to complete a variety of assignments In‑depth knowledge in technical or specialty area Applies advanced skills to resolve complex problems independently May modify process to resolve situations Works independently within established procedures; may receive general guidance on new assignments May provide general guidance or technical assistance to less experienced team members Training and Work Schedules: Your new hire training will take place 8:00am‑5:00pm CST, mandatory attendance is required. This position is full‑time (40 hours/week). Employees are required to have flexibility to work any of our shift schedules during our normal business hours of Monday‑Friday, 8:00am‑5:00pm CST. Remote Details: You will work remotely, full‑time. It will require a dedicated, quiet, private, distraction‑free environment with access to high‑speed internet. We will provide you with the computer, technology and equipment needed to successfully perform your job. You will be responsible for providing high‑speed internet. Internet requirements include the following: Maintain a secure, high‑speed, broadband internet connection (DSL, Cable, or Fiber) at the remote location. Dial‑up, satellite, WIFI, Cellular connections are NOT acceptable. Download speed of 15Mbps (megabyte per second); Upload speed of 5Mbps; Ping Rate Maximum of 30ms; Hardwired to the router; Surge protector with Network Line Protection for CAH issued equipment. Anticipated hourly range: $21.40 per hour – $30.60 per hour Benefits Medical, dental and vision coverage Paid time off plan Health savings account (HSA) 401(k) savings plan Access to wages before pay day with myFlexPay Flexible spending accounts (FSA) Short‑ and long‑term disability coverage Work‑Life resources Paid parental leave Healthy lifestyle programs Cardinal Health supports an inclusive workplace that values diversity of thought, experience and background. We celebrate the power of our differences to create better solutions for our customers by ensuring employees can be their authentic selves each day. Cardinal Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, ancestry, age, physical or mental disability, sex, sexual orientation, gender identity/expression, pregnancy, veteran status, marital status, creed, status with regard to public assistance, genetic status or any other status protected by federal, state or local law. #J-18808-Ljbffr Cardinal Health