Senior Coordinator, Individualized Care (Case Manager)

Cardinal Health, Inc.; Town of Texas (WI); Remote; USD 60,000 - 80,000; Full time

Job summary

An established industry player is seeking a dedicated Case Manager to enhance patient access to vital therapies. This role involves guiding patients through their healthcare journey, ensuring they receive the necessary support and resources for their treatment. You will be the first point of contact for patients, addressing inquiries, resolving issues, and collaborating with various stakeholders to ensure timely access to therapies. This position offers the opportunity to make a significant impact on patients' lives while working in a supportive and innovative environment. If you are passionate about patient care and thrive in a fast-paced setting, this role is perfect for you.

Benefits

Medical, dental and vision coverage

Paid time off plan

Health savings account (HSA)

401k savings plan

Flexible spending accounts (FSAs)

Short- and long-term disability coverage

Work-Life resources

Paid parental leave

Healthy lifestyle programs

Qualifications

• 3-6 years of experience in a related field preferred.
• High School Diploma or equivalent experience required.

Responsibilities

• Support patient access to therapy through reimbursement services.
• Investigate patient insurance benefits and facilitate coverage.
• Provide exceptional customer service and resolve inquiries.

Skills

Customer Support

Problem Solving

Communication Skills

Time Management

Insurance Knowledge

Technical Proficiency

Education

High School Diploma or GED

Technical Certification

Tools

CRM Software

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.

Responsibilities

The Case Manager supports patient access to therapy through Reimbursement Support Services in accordance with the program business rules and HIPAA regulations. This position is responsible for guiding the patient through the various process steps of their patient journey to therapy. These steps include patient referral intake, investigating all patient health insurance benefits (pharmacy and medical benefits), and proactively following up with various partners including the insurance payers, specialty pharmacies, support organizations, and the patient/physician to facilitate coverage and delivery of product in a timely manner.

• First point of contact handling inbound calls, with ability to determine needs and provide one call resolution
• Process enrollments via inbound fax, phone, and electronically.
• Provide world-class service and receive inbound calls from patients, healthcare provider offices, SPs, and customers, striving for one-call resolution.
• Mediate effective resolution for complex payer/pharmacy issues toward a positive outcome to de-escalate
• Must meet the daily task and benefit investigation goals associated with a high enrollment volume/low patient interaction program.
• Investigate and resolve patient/physician inquiries and concerns in a timely manner
• Proactive follow-up with various contacts to ensure patient access to therapy
• Demonstrate superior customer support talents
• Prioritize multiple, concurrent assignments and work with a sense of urgency
• Must communicate clearly and effectively in both a written and verbal format
• Must demonstrate a superior willingness to help external and internal customers
• Working alongside teammates to best support the needs of the patient population or will transfer caller to appropriate team member (when applicable)
• Maintain accurate and detailed notations for every interaction using the appropriate database for the inquiry
• Must self-audit intake activities to ensure accuracy and efficiency for the program
• Make outbound calls to patient and/or provider to discuss any missing information as applicable
• Assess patient’s financial ability to afford therapy and provide hand on guidance to appropriate financial assistance
• 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
• Handle escalations and ensure proper communication of the resolution within required timeframe agreed upon by the client
• Ability to effectively mediate situations in which parties are in disagreement to facilitate a positive outcome
• Concurrently handle multiple outstanding issues and ensure all items are resolved in a timely manner to the satisfaction of all parties
• Enter detailed information into company proprietary software while conversing via telephone
• Place outbound phone calls for patient follow ups or confirmations
• Proactively following up with various partners including the insurance payers, specialty pharmacies, support organizations, and the patient/physician to facilitate coverage and delivery of product in a timely manner.
• Conducting initial assessments to understand patient /HCP needs and gather information to determine eligibility
• Evaluating client needs and making appropriate referrals to relevant programs or services.
• Collaborate with both internal and external teams, focusing on problem-solving and teamwork.
• Cultivate innovation by consistently monitoring systems, processes, and potential care gaps, offering new ideas and solutions to elevate the support program.
• Proactively document and share reimbursement and other knowledge with patient support program team members through resources, consultation for complex cases, and special projects as requested.
• Consistently maintain and document accurate data, including insurance, coverage approvals, on-going coverage requirements, and all patient and provider interactions.
• Gain and sustain proficiency in use of the manufacturer’s CRM tool to document work and progress the patient journey. Consistently leverage CRM reporting tools and data analytics to make strategic decisions while prioritizing patient and customer needs, while tracking and communicating areas within the CRM where refinement would be beneficial.
• Display high emotional intelligence and use professional communication to foster strong working relationships with colleagues both inside and outside the organization.
• Provide caseload coverage outside of assigned duties as needed.
• Ensure compliance with company and manufacturer policies.

Qualifications

• 3-6 years of experience, preferred
• High School Diploma, GED or technical certification in related field or equivalent experience, preferred

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

TRAINING AND WORK SCHEDULES:Your new hire training will take place 8:00am-5:00pm CT, mandatory 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, 7:00am- 7:00pm CT.

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 - $30.70 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:05/10/2025 *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.