Dedicated Case Coordinator Dallas
Pfizer
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Benefits offered by this job
Job summary
Pfizer is seeking a dedicated Inflammation and Immunology Dedicated Case Coordinator (DCC) to own end-to-end patient cases, guiding reimbursement and access across HUB enrollment to post-fill follow-up. This field-based, non-promotional role partners with patients, providers, payers, and vendors to ensure timely access to PDPA and VFM products.
The DCC acts as the primary contact for reimbursement status updates and works cross-functionally to navigate benefits investigations, prior
Qualifications
- B.S. or B.A. Degree and 8+ years of pharmaceutical (or related) experience in customer-facing roles/functions.
- Working proficiency in Polaris CRM including case management and documentation, prescription triage, PA/appeal/PEF documentation.
- Experience conducting benefit investigation and verification directly with payers, and working knowledge of prior authorization and appeals processes.
- Knowledge of copay programs, copay maximizers and accumulators, vouchers, and interim care programs.
- Ability to own a high volume of concurrent cases across a patient journey with disciplined documentation and follow-through.
Responsibilities
- Own 100% of assigned cases and drive continual management of the patient journey from enrollment through post-fill follow-up.
- Be central point-of-contact for patients/caregivers and HCPs regarding reimbursement and access status.
- Coordinate with providers, payers, and vendors to ensure timely access and coverage.
- Manage BI/BV calls with payers and patients for cases with 3rd party restrictions.
- Coordinate with IQVIA/MDX and other partners on patient assessments and tests.
Skills
Education
Tools
Job description
The Inflammation and Immunology Dedicated Case Coordinator (DCC) is a non-promotional, field-based role that supports patients’ access to PDPA and VFM products when prescribed by a licensed healthcare provider. The DCC owns the continual management and progression of the patient journey — from HUB enrollment through post-fill follow-up — working directly with patients, providers, payers, HUB partners, and third-party vendors. It is a dual patient- and HCP-facing role spanning a patient journey, and the colleague in this role carries 100% ownership of every case in their assigned geography.
The DCC is a subject-matter expert on reimbursement, access, and coverage issues that can educate patients/caregivers and healthcare providers on matters relating to reimbursement, access, and coverage. The DCC will serve as the primary point of contact for patients/caregivers and healthcare providers regarding the status of their request for reimbursement support and access assistance and will also provide updates to patients/caregivers and healthcare providers on their status as appropriate. The DCC holds end-to-end case ownership: benefits investigation and verification, prior authorization and appeals support, appointment and baseline assessment coordination, Interim Care and voucher administration, copay support, prescription triage, and scheduled post-fill follow-up.
Own 100% of assigned cases and drive the continual management and progression of the patient journey, from HUB enrollment through post-fill follow-up
Be the central point-of-contact for patients/caregivers and HCP providers regarding the status of their request for reimbursement and access support related to a patient case.
Answer questions from patients/caregivers relating to access and coverage
Maintain a clear understanding of the patient access journey and requirements at each stage of the process, as well as the role played by patients/caregivers and HCP providers in the process
Support access with HCPs and opted-in patients/caregivers who have been prescribed a PDPA OR VFM product
Conduct the Summary of Benefits (SOB) discussion required for every HUB-enrolled patient, reviewing both the product benefit structure, any associated cost and the baseline appointments for VFM
Obtain all missing information on the Patient Enrollment Form (PEF) and verify the testing, voucher, and Interim Care options selected by the HCP office
Walk the patient through out-of-pocket cost, deductibles, copay options, and the reimbursement program, including the impact of maximizers and accumulators
Verify coverage for the product and for required baseline tests across both PBM and major medical insurance for VFM
Oversee the entire prior authorization process, including submission and verification with both the patient and the provider
Conduct benefit investigation and verification (BI/BV) calls directly with payers and patients for patients with 3rd party restrictions
Confirm and communicate product coverage, cost, prior authorization and appeal requirements, Interim Care program PA and Appeal deadlines, and baseline assessment tests to HCP and patient
Schedule, reschedule and confirm patient appointments in coordination with the patient, the provider, and the vendor
Secure the appropriate confirmation communication back from the provider (CFT)
Coordinate compliantly with IQVIA/MDX on patient assessment tests — confirm tests are completed and reschedule where needed
Once IC is approved, manage all Interim Care (IC) program administrative requirements and deadlines with the provider and the patient, including Extended Interim Care programs
Confirm voucher need and eligibility with the provider and patient, and triage the voucher for shipment to the patient
Maintain Copay portal access and help approved commercial patients secure a copay card
Own copay eligibility attestation responsibility
Follow up with the patient post-fill to confirm the copay card is functioning correctly
Triage the voucher, paid prescription, and/or Interim Care fill within Polaris
Contact the patient at 10 days and again at 45 days post-prescription, confirming that no logistical or financial questions remain outstanding
Manage and update various case types in Polaris, using its texting, faxing, and prescription triage capabilities
View and interpret prior authorization, appeal, and PEF documentation for accuracy
Share and manage cases with HUB partners across all patient journeys
Coordinate as appropriate with other Pfizer colleagues and Patient Support Program/HUB employees, via tasks and secure messages to requests for action, to help resolve problems with individual patient cases
Maintain case comments as a real-time account of the patient journey, including a recap of every call made to the HCP and the patient
Use the Kite works encrypted email system for correspondence with patients and providers
Manage the Docusign process with patients to obtain required consents
Develop an organized, concise, and compliant way to manage assigned patient cases within established time frames
Report adverse events (AEs) in accordance with company requirements — AE reporting volume is elevated in this role, patient contact is more frequent and spans the entire patient journey
Operate within the tighter content controls and system permissions that apply to this role
Compliantly communicate the access landscape and options to patients/caregivers and HCPs
Link the patient access support to meet patient needs, using Brand RC-approved materials
Conduct yourself with the utmost discretion and confidentiality
Adhere to strict company compliance guidelines and procedures
Work and lead cross-functionally with internal and external colleagues, compliantly, to improve the patient access journey
Effectively link customer insights to the offerings and approved resources to address patient access barriers
Build trust through compliant follow-up and knowledge of the access journey
Demonstrate excellence in responsible business communication, both written and spoken
B.S. or B.A. Degree 8+ years of pharmaceutical (or related) experience in customer-facing roles/functions.
6 months minimum as a FRM, PAC, FAS or similar experience in access and Reimbursement and working with Polaris CRM System.
Working proficiency in Polaris, including case management and documentation, prescription triage, and interpretation of PA, appeal, and PEF documentation
Demonstrated ability to communicate directly with patients, with providers, and with cross-functional colleagues
Experience conducting benefit investigation and verification directly with payers, and working knowledge of prior authorization and appeals processes
Working knowledge of copay programs, copay maximizers and accumulators, vouchers, and free or interim care programs
Ability to own a high volume of concurrent cases across a patient journey that could average approximately 20 days, with disciplined documentation and follow-through
Ability to meet adverse event reporting obligations in a role with frequent, direct patient contact
Strong understanding of Reimbursement, Government Payment Systems, Specialty Pharmacy Networks, Co-Pay Assistance Programs, and knowledge of the Specialty Medication area.
Appropriate and compliant communication and collaboration with cross-functional field-based colleagues (Sales, Medical, FRM, PCA/SAS, KAD, Government Relations) to ensure optimal and appropriate patient access in both in-patient and out-patient accounts.
Alignment with HQ stakeholders to ensure appropriate understanding of, and support for patient access (e.g., Brand and Customer Marketing teams and PCA/SAS teams).
Experience in a Patient and/or customer facing role requiring access and reimbursement education.
Experience working with a HUB.
Experience with Kite works or a comparable encrypted email platform, Docusign, and copay portal administration
Experience coordinating with third-party vendors on patient assessment, testing, or specialty pharmacy logistics (e.g., IQVIA/MDX, Sonexus)
Experience supporting Interim Care, free goods, or bridge programs
Experience with both pharmacy benefit (PBM) and major medical benefit coverage pathways
Work Location Assignment: Remote colleagues from home 5 days a week or are field-based colleagues that are not affiliated with a Pfizer site.
Ability to travel – Approximately 10% to 20%
Time Zone: Central Time Zone
Eligible for Relocation Package – NO
The annual base salary for this position ranges from $162,900.00 to $271,500.00. In addition, this position is eligible for participation in Pfizer’s Global Performance Plan with a bonus target of 20.0% of the base salary and eligibility to participate in our share based long term incentive program. We offer comprehensive and generous benefits and programs to help our colleagues lead healthy lives and to support each of life’s moments. Benefits offered include a 401(k) plan with Pfizer Matching Contributions and an additional Pfizer Retirement Savings Contribution, paid vacation, holiday and personal days, paid caregiver/parental and medical leave, and health benefits to include medical, prescription drug, dental and vision coverage. Learn more at Pfizer Candidate Site – U.S. Benefits | (uscandidates.mypfizerbenefits.com). Pfizer compensation structures and benefit packages are aligned based on the location of hire. The United States salary range provided does not apply to Tampa, FL or any location outside of the United States.
This role is posted in multiple locations. If you are applying for the role in an secondary job posting location where pay transparency regulations apply, your Talent Advisor will share the local pay information with you during the first interview.
Relocation assistance may be available based on business needs and/or eligibility.
Candidates must be authorized to be employed in the U.S. by any employer.
U.S. work visa sponsorship (such as TN, O-1, H-1B, etc.) is not available for this role now or in the future.
Pfizer reports payments and other transfers of value to health care providers as required by federal and state transparency laws and implementing regulations. These laws and regulations require Pfizer to provide government agencies with information such as a health care provider’s name, address and the type of payments or other value received, generally for public disclosure. Subject to further legal review and statutory or regulatory clarification, which Pfizer intends to pursue, reimbursement of recruiting expenses for licensed physicians may constitute a reportable transfer of value under the federal transparency law commonly known as the Sunshine Act. Therefore, if you are a licensed physician who incurs recruiting expenses as a result of interviewing with Pfizer that we pay or reimburse, your name, address and the amount of payments made currently will be reported to the government. If you have questions regarding this matter, please do not hesitate to contact your Talent Acquisition representative.
Pfizer is committed to equal opportunity in the terms and conditions of employment for all employees and job applicants without regard to race, color, religion, sex, sexual orientation, age, gender identity or gender expression, national origin, disability or veteran status. Pfizer also complies with all applicable national, state and local laws governing nondiscrimination in employment as well as work authorization and employment eligibility verification requirements of the Immigration and Nationality Act and IRCA. Pfizer is an E-Verify employer. This position requires permanent work authorization in the United States.
Pfizer endeavors to make www.pfizer.com/careers accessible to all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process and/or interviewing, please email disabilityrecruitment@pfizer.com . This is to be used solely for accommodation requests with respect to the accessibility of our website, online application process and/or interviewing. Requests for any other reason will not be returned.
To learn more about acceptable and prohibited uses of AI during the recruitment process, please review our candidate AI-use guidelines available on Pfizer Careers .
Pfizer is a global leader in biopharmaceuticals, driving scientific innovation to develop transformative therapies that enhance healthcare and address critical medical challenges.
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