Clinical Project Liaison

Software Methods, Incorporated; Media (Delaware County); On-site; USD 45,000 - 65,000; Full time

Job summary

Software Methods, Incorporated in Media, PA is seeking a full-time Clinical Project Liaison to support our client with on-site care coordination. The CPL handles transitions of care from outpatient infusion to home infusion, coordinates drug deliveries, and assists with pharmacogenomic (PGx) testing intake.

You will work with plan sponsors, PBMs, and care teams to ensure eligibility, track interactions in CRM, support cost-containment through biosimilar options, and help patients access

Qualifications

• Minimum 3+ years customer service experience within healthcare or insurance.
• Clinical background such as nursing or pharmacy-related experience required.
• Excellent written and verbal communication skills.

Responsibilities

• Ensure plan members meet plan eligibility requirements.
• Act as primary point of contact for plan members.
• Serve as plan member advocate and enhance collaboration between member, provider, and assistance program representatives.
• Document interactions in the CRM software in a timely manner.
• Manage transitions of care from outpatient infusion to home infusion and coordinate drug delivery and supplies.
• Assist with PGx testing intake and biosimilar transitions to aid cost-containment.
• Coordinate access to patient assistance programs and financial forms.
• Verify drug dispenses and compile audit trails.

Skills

Customer service

Insurance verification

Healthcare reimbursement

Pharmaceutical experience

Clinical experience

Communication skills

Multi-tasking

MS Office

Tools

CRM software

Envoy ticketing system

Microsoft Excel

Job description

Software Methods is seeking a full-time Clinical Project Liaison to assist our client in the Media, PA area. This is 100% on-site.

Clinical Project Liaison (CPL) is responsible for customer service and patient case coordination. This position will manage the transitions of care for outpatient infusion to home infusion, coordinate delivery drug and ancillary supplies, as well as compare pricing between our vendors to provide the best value for our clients. The CPL will also be directly involved with the intake process and coordination of the companies new pharmacogenomic (PGx) testing program. The CPL will also assist with transitioning members to biosimilar products to aid in cost-containment.

Additionally, the CPL will help plan members access financial assistance programs. The CPL will follow up with members, pharmacies, health care providers and/or financial assistance programs to confirm shipment/receipt of drug shipments. From time to time, the CPL will be in contact with TPAs, PBMs and Payers (Funds, Plan Sponsors, Insurers) to gather information and assist plan members. Various tasks will be assigned to help the medical team with special projects.

Key Responsibilities

• Ensure that plan members meet plan eligibility requirements
• Act as primary point of contact for plan members
• Serve as plan member advocate and enhance the collaborative relationship between the plan member, health care provider, and patient assistance program representatives
• Document/record all interactions with members, health care providers, pharmacies, and financial assistance entities in the Customer Relationship Manager software (“CRM”) in a timely manner
• Manage the transitions of care for outpatient infusion to home infusion, coordinate delivery drug and ancillary supplies, as well as compare pricing between our vendors to provide the best value for our clients
• Process the intake and coordination of the pharmacogenomic (PGx) testing program
• Assist with connecting members to biosimilar products to provide patient access and plan savings
• Provide exceptional customer service to internal and external customers; resolve any customer requests in a timely and accurate manner; escalates complaints accordingly
• Review pending activities/events and specific customer requests to ensure excellent customer service and customer experience
• Demonstrate proficiency and full understanding of the Company plan member database including data elements, definition of case statuses and outcomes, case documentation requirements and the importance of meeting company metrics
• Research and identify available financial assistance programs for specialty drugs that are prescribed for active members
• Coordinate access to patient assistance programs; provide assistance to plan members and physician staff to complete all necessary financial assistance program forms and applications in a timely manner
• Coordinate delivery and verify receipt of financial assistance forms and applications to plan members, physician offices, and financial assistance programs
• Verify drug dispenses to members and compile audit trail of source documents and information for each dispense
• Report any financial assistance program trends to supervisor
• Communicate with plan member’s health plan sponsor, Fund, or PBM as needed
• Recommend improved processes and management methods to generate workflow optimization
• Help with testing Envoy tickets prior to launch
• Suggest/add new tickets into Envoy to help overall functionality and site improvements
• Gather insights and recommendations from other Care Coordinators to present to management
• Perform such other duties as needed or assigned by management

Requirements

• Minimum 3+ years customer service experience, insurance verification, healthcare reimbursement and/or pharmaceutical experience required
• Clinical experience required such as nursing, medical assistant, pharmacy technician or pharmacist
• Excellent written and oral communication skill
• Ability to multi-task and handle consistent workflow
• Time management and prioritization skills
• Computer, email, and MS Office competency

Unable to sponsor visas for this position.