Lead | Patient Services - US Healthcare

Cognizant Technology Solutions Corporation; Taguig; Presencial; PHP 700.000 - 1.000.000; Jornada completa

Descripción de la vacante

Cognizant in Taguig is seeking a Senior Specialist for Patient Assistance Program operations to serve as SME, provide real-time guidance, ensure quality and compliance, and resolve complex cases.

You will lead coaching, audits, and reporting, handle escalations, and collaborate with stakeholders while adhering to HIPAA and client expectations.

This role requires 4-5 years US Healthcare PAP experience, 1-2 years as SME/lead, and onsite graveyard shift with fixed weekends off.

Formación

• Bachelor's degree in a healthcare or related field.
• 4–5 years of US Healthcare PAP/Healthcare Operations experience.
• 1–2 years experience as Senior Specialist/SME/Team Lead.
• Willing to work onsite in Taguig City.
• Willing to work graveyard shift with fixed weekends off.

Responsabilidades

• Provide real-time guidance to PAP Specialists on complex cases and exceptions.
• Escalation point for guidelines, eligibility decisions, approvals/denials, renewals, and patient support processes.
• Review and resolve cases outside standard SOPs.
• Conduct quality audits and call monitoring for compliance and service excellence.
• Identify trends, gaps, and errors; recommend corrective actions and improvements.
• Support onboarding, refresher training, calibration sessions, and coaching.
• Prepare operational reports, KPI summaries, and status updates for leadership and clients.
• Ensure adherence to HIPAA, quality standards, compliance, and audit readiness.

Conocimientos

PAP operations

Escalation management

Quality audits

Training delivery

Stakeholder management

Coaching

Educación

Bachelor's degree in Healthcare, Pharmacy, Life Sciences, or related fields

Herramientas

Excel

Power BI

Salesforce Health Cloud

Descripción del empleo

Serve as the primary subject matter expert for Patient Assistance Program (PAP) operations by providing real-time support, ensuring quality and compliance, resolving complex cases, and driving knowledge excellence across the team.

Key Responsibilities

• Provide real-time guidance and support to Patient Assistance Program Specialists on complex cases and exceptions.
• Act as the escalation point for application guidelines, eligibility decisions, approval and denial scenarios, renewals, prescription status, and patient support processes.
• Review and resolve cases that fall outside standard operating procedures.
• Conduct quality audits and call monitoring activities to ensure compliance and service excellence.
• Identify trends, process gaps, and recurring errors, and recommend corrective actions and process improvements.
• Support onboarding, refresher training, knowledge calibration sessions, and coaching initiatives.
• Prepare operational reports, KPI summaries, and status updates for leadership and client stakeholders.
• Ensure adherence to HIPAA, quality standards, compliance requirements, and audit expectations.

Qualifications

• Bachelor's degree required; Healthcare, Pharmacy, Allied Health, Life Sciences, Business, or related fields preferred.
• At least 4-5 years of experience in US Healthcare, Patient Assistance Programs (PAP), Patient Access, Specialty Pharmacy, Reimbursement Support, or Healthcare Operations.
• Minimum of 1-2 years experience as a Senior Specialist, SME, Quality Analyst, Team Lead, or Subject Matter Expert.
• Strong knowledge of patient assistance programs, healthcare eligibility, coverage processes, and patient support operations.
• Excellent communication, coaching, stakeholder management, and problem-solving skills.
• Experience managing escalations, compliance requirements, and complex case resolutions.
• Willing to work onsite in Taguig City.
• Willing to work on a Graveyard Shift schedule with fixed weekends off.

Preferred Skills

• Expertise in Patient Assistance Programs (PAP), Patient Access, Benefits Verification, Reimbursement Support, Specialty Pharmacy, or Healthcare Provider Services.
• Experience performing Quality Assurance, Call Monitoring, Root Cause Analysis, Process Improvement, and Training Delivery.
• Advanced reporting and analytics skills using Excel, Power BI, or similar tools.
• Experience with Salesforce Health Cloud, CRM platforms, Five9, or healthcare support systems.
• Strong understanding of HIPAA, healthcare compliance, quality management, and audit readiness.

Why Join Us:

At Cognizant, we don’t just offer jobs—we build careers that thrive in the digital era.

• Growth That Matters – Clear career paths, continuous learning, and opportunities to move into leadership or specialized roles. You’re not just filling a seat—you’re building a future.
• Support That Empowers – A collaborative culture where your voice is heard, your ideas matter, and your well-being is prioritized through strong benefits and work-life balance.
• Impact That Inspires – Work on global accounts that shape industries, influence millions of users, and give you a sense of purpose beyond the paycheck.

Your future starts here—grow, thrive, and make an impact with Cognizant.