Case Manager

Cardinal Health, Inc.; Town of Texas (WI); Remote; Full time

Job summary

A leading healthcare company is seeking customer service representatives to assist patients in navigating their insurance coverage and benefits. This full-time remote position requires strong attention to detail and customer service skills, with training provided. Successful candidates will support patients in obtaining necessary therapies and managing their healthcare needs.

Benefits

Medical, dental and vision coverage

Paid time off plan

401k savings plan

Short- and long-term disability coverage

Paid parental leave

Qualifications

• Previous customer service experience preferred.
• Demonstrated high level customer service.
• Experience conducting patient health insurance benefit investigations preferred.

Responsibilities

• First point of contact on inbound calls, determines needs, and handles accordingly.
• Conducts benefits investigations to identify patients’ insurance plan coverage.
• Must demonstrate a superior willingness to help external and internal customers.

Skills

Customer Service

Attention to Detail

Critical Thinking

Education

High School Diploma or Equivalent

Job description

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.

Together, we can get life-changing therapies to patients who need them—faster.

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

• 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

Responsibilities

• Must demonstrate a superior willingness to help external and internal customers
• 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
• Conducts benefits investigations to identify patients’ insurance plan coverage for medications, procedures, and travel and lodging
• Provides detailed activity notes as to what appropriate action is needed for the Benefit Investigation processing
• Assist with coordination of travel and lodging associated with patient therapy
• Working alongside teammates to best support the needs of the patient population or transfer caller to appropriate team member (when applicable)
• Resolve patient's questions and any representative for the patient’s concerns regarding status of their request for assistance
• Update internal treatment plan statuses and external pharmacy treatment statuses
• Maintain accurate and detailed notations for every interaction using the appropriate database for the inquiry
• Make all outbound calls to patient and/or provider to discuss any missing information and/or benefit related information
• Notify patients, physicians, practitioners, and/or clinics of any financial responsibility of services provided as applicable
• Responsible for placing all outbound calls to ensure the process is complete
• Assess patient’s financial ability to afford therapy and provide hand on guidance to appropriate financial assistance
• Must follow through on all benefit investigation rejections, including Prior Authorizations, Appeals, etc. All avenues to obtain coverage for the product must be fully exhausted
• Documentation must be clear and accurate and stored in the appropriate sections of the database
• Must track any payer/plan issues and report any changes, updates, or trends to management
• Ability to search insurance options and explain various programs to the patient while helping them to select the best coverage option for their situation
• Handle all escalations and ensure proper communication of the resolution within required timeframe agreed upon by the client
• Responsible for reporting any payer issues to the appropriate team
• Must self-audit activities to ensure accuracy and efficiency for the program

Qualifications

• Previous customer service experience, preferred
• High School diploma or equivalent, preferred
• Demonstrated high level customer service
• Experience conducting and documenting patient medical health insurance benefit investigations, prior authorizations, and appeals, preferred
• Knowledge of Medicare, Medicaid and Commercially insured payer common practices and policies, preferred
• Knowledge of the Health Insurance Market Place and the Affordable Care Act preferred
• Knowledge of ICD9/ICD10 coding is preferred
• Critical and creative thinking, preferred
• Important to have a strong attention to detail

TRAINING AND WORK SCHEDULES: Your new hire training will take place 8:00am-5:00pm CST, mandatory on camera 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 (megabyte per second)
• Ping Rate Maximum of 30ms (milliseconds)
• Hardwired to the router
• Surge protector with Network Line Protection for CAH issued equipment

Anticipated hourly range:$21.50 per hour - $30.65 per hour

Bonus eligible:No

Benefits:Cardinal Health offers a wide variety of benefits and programs to support health and well-being.

• Medical, dental and vision coverage

• Paid time off plan

• Health savings account (HSA)

• 401k savings plan

• Access to wages before pay day with myFlexPay

• Flexible spending accounts (FSAs)

• Short- and long-term disability coverage

• Work-Life resources

• Paid parental leave

• Healthy lifestyle programs

Application window anticipated to close:07/18/2025 *if interested in opportunity, please submit application as soon as possible. The hourly range listed is an estimate. Pay at Cardinal Health is determined by multiple factors including, but not limited to, a candidate’s geographical location, relevant education, experience and skills and an evaluation of internal pay equity.

Candidates who are back-to-work, people with disabilities, without a college degree, and Veterans are encouraged to apply.

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.