Senior Biologics Coordinator

AllerVie Health; United States; Remote; USD 110,000 - 170,000; Full time

Job summary

AllerVie Health is seeking a Senior Biologics Coordinator to steward biologics patients across multiple locations, focusing on buy and bill and specialty pharmacy paths. You will drive patient continuity and in-office revenue growth by converting eligible patients and coordinating with clinical teams.

As a senior member, you will lead Biologics Coordinators, manage PA renewals, monitor time to therapy, and report on metrics. Travel to sites is required.

Qualifications

• Strong understanding of buy and bill reimbursement models and specialty pharmacy operations.
• Experience with prior authorization processes and benefits investigation, including payer-specific buy and bill coverage analysis.
• Understanding of Revenue Cycle Management and Biologics Billing.
• Excellent organizational and project management skills across multiple locations.
• Strong written and verbal communication skills.
• Creative problem-solving and sound decision-making abilities.
• Strategic and analytical mindset with keen attention to detail.
• Ability to lead, train, and motivate a team.

Responsibilities

• Oversee enrollment and active management of patients on buy and bill and SP across locations.
• Monitor eligibility changes, formulary updates and payer policy shifts.
• Collaborate with clinical teams on alternatives when coverage is denied.
• Provide day-to-day leadership, training, and workflow oversight.
• Track metrics such as new starts, SP conversions, and injections.
• Coordinate with pharmacy partners and clinics to minimize therapy gaps.

Skills

Buy and Bill

Specialty Pharmacy

Prior Authorization

Revenue Cycle Management

Communication Skills

Problem Solving

Leadership

Team Training

Travel Flexibility

Data Analysis

Tools

PACS certification

Job description

The following statements are intended to describe the general nature and level of work being performed. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills of personnel so classified.

SUMMARY

The Senior Biologics Coordinator is responsible for the day-to-day stewardship of biologics patients across multiple locations and practices, covering both buy and bill (B&B) and specialty pharmacy (SP) pathways. Eligible buy and bill drugs include Xolair, Nucala, Fasenra, Tezspire, and Exdensur. The primary long-term objective is to protect and grow in-office injection revenue by converting eligible patients to a buy and bill model while maintaining continuity of therapy for patients who remain on specialty pharmacy. This role serves as the strategic bridge between specialty pharmacy operations and in-office buy and bill administration, driving both patient continuity and financial growth.

This role proactively identifies buy and bill eligible patients, manages conversion opportunities at key inflection points (renewals and denials), and coordinates closely with pharmacy partners, patients, and the clinical team to keep appropriate patients in-office. The Senior Biologics Coordinator also oversees SP patient tracking, including new starts, transfers, and time to therapy, and stewards IVIG/SCIG (IG) patients in partnership with Lux Infusion with a view toward long-term infusion clinic development.

As a senior member of the biologics team, this position serves as the subject matter expert and escalation point for Biologics Coordinators and Assistants. It provides day-to-day leadership, training, and workflow oversight across assigned locations, and operates in close partnership with benefits and prior authorization (PA) teams, revenue cycle management (RCM), pharmacy partners, and clinical staff. The Senior Biologics Coordinator will report to the Biologics Manager, and Biologics Coordinators will report to this role.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Buy and Bill Drug Oversight

• Oversee enrollment and active management of patients on Xolair, Nucala, Fasenra, Tezspire, and Exdensur across assigned locations to ensure continuity of therapy and identification of conversion opportunities.
• Monitor eligibility changes, formulary updates, and payer policy shifts for these drugs that may open new buy and bill conversion pathways.
• Collaborate with the clinical team on therapeutic alternatives when these drugs face barriers to coverage.
• Monitor inventory and drug ordering for assigned sites, including review of daily inventory completion and identification of excess drug inventory.

Specialty Pharmacy Oversight

• Oversee SP patient management across assigned locations, including new starts, referrals, transfers, and patients with open or pending SP fills.
• Monitor time to therapy for SP patients and work with pharmacy partners, clinics, and PA teams to resolve delays.
• Serve as the point of contact for specialty pharmacy partners on escalated dispensing, shipment, and patient access issues.
• Identify SP patients who may be candidates for conversion to buy and bill and route them into the conversion pipeline.
• Manage and monitor PA renewals for buy and bill and SP patients to ensure timely authorization and minimize gaps in therapy.
• Lead benefits investigation for conversion candidates, including payer-specific buy and bill coverage analysis and appeal strategy.
• Review complex or escalated PA denials and appeals and guide Biologics Coordinators on the next steps.
• Identify and escalate missed PA renewal cases and delegate corrective actions to team members.
• Partner with RCM to monitor claims for buy and bill injections, ensuring accurate billing and expected reimbursement levels.
• Triage, resolve, or delegate follow-up on escalated claims and denials between Legacy and Practice teams.
• Support preparation and review of monthly reporting packages, including new starts (buy and bill and SP), active buy and bill patient counts, buy and bill conversion metrics, no starts / no shows with action plans, and end-of-month reconciliation.
• Identify revenue risk from leakage of these drugs to specialty pharmacy dispensing and develop action plans to address with clinic and pharmacy teams.

Buy and Bill Stewardship & Conversion

• Identify all active patients on buy and bill eligible drugs and manage proactively to maintain in-office administration.
• Conduct systematic review of these patients at renewal to assess buy and bill conversion eligibility and initiate PA and benefits work accordingly.
• Pursue buy and bill alternative pathways at the time of drug denial, working with benefits and PA teams to identify formulary substitutes.
• Coordinate with pharmacy partners and patients to facilitate smooth transitions from specialty pharmacy dispensing to in-office buy and bill.
• Maintain and report on a conversion pipeline across assigned locations, tracking patients by status (candidate, in-process, converted, ineligible).

Operations & Team Leadership

• Provide day-to-day direction, training, and support to Biologics Coordinators and Assistants across assigned locations.
• Review and verify patient schedules to ensure appropriate drug ordering based on scheduled patients and current inventory levels.
• Serve as the first level of escalation for Biologics Coordinators, resolving issues directly or escalating to the Biologics Manager as needed.
• Assist the Biologics Manager with weekly team meetings by preparing and presenting metrics such as new starts, SP conversions, orders, time to therapy, and billed injections.
• Conduct chart audits to ensure BE completion and accurate biologics documentation, notes, and reminders.
• Identify operational obstacles involving clinics, vendors, and biologics partners and drive resolution.
• Serve as a point of contact for providers, manufacturers, and third-party vendors.
• Support onboarding and cross-training of new team members and recognize and celebrate team successes.
• Travel to assigned locations as needed to support operations, providers, and staff.
• Oversight and steward IVIG/SCIG patients through the Lux Infusion platform, maintaining coordination with pharmacy and patient contacts.
• Track patient concentration by location to inform long-term infusion clinic planning and resource allocation.
• Serve as the primary liaison for IG-related coordination issues across clinics, pharmacy, and patient stakeholders.

QUALIFICATIONS

To perform this job successfully, the candidate must be able to perform each duty adequately in a culturally competent environment. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

• Strong understanding of buy and bill reimbursement models and specialty pharmacy operations
• Experience with prior authorization processes and benefits investigation, including payer-specific buy and bill coverage analysis
• Understanding of Revenue Cycle Management and Biologics Billing
• Excellent organizational and project management skills with the ability to manage a multi-location patient population
• Strong communication skills, both verbal and written
• Creative problem-solving and sound decision-making ability
• Strategic and analytical mindset with keen attention to detail
• Excellent relationship management skills; ability to work collaboratively with internal and external teams
• Ability to lead, train, and motivate a team
• Accountability, adaptability, and discretion
• Ability to travel across assigned locations

SKILLS REQUIRED

• Clinical or RCM experience with medical prior authorizations (required)
• PACS certification or at least two years of prior authorization experience
• Minimum of two years of experience in a biologics coordinator role or equivalent, with experience in both buy and bill and specialty pharmacy workflows
• Experience with specialty biologics, IVIG/SCIG, or infusion therapy management
• Prior experience training or leading a team preferred
• Ability to analyze data and reports to drive operational decisions