Sr/Care Manager, Patient Support Services – Remote

IQVIA INC (US10); Northborough (MA); Remote; USD 80,000 - 100,000; Full time

Job summary

A leading healthcare solutions provider is seeking a Care Manager to work remotely. Responsibilities include performing calls to obtain eligibility information, assisting customers with support services, and ensuring HIPAA compliance. The ideal candidate will have experience in medical billing and exceptional communication skills. A high school diploma is required, and a workspace free of distractions is essential.

Qualifications

• Minimum one year experience in medical billing, reimbursement, insurance verification, or related medical office experience.
• Experience with data entry (minimum three months) and ability to type 30 wpm+.
• Computer savvy with ability to navigate multiple tabs, monitors, and applications.

Responsibilities

• Perform outbound calls to obtain appropriate information and document accurately.
• Respond to in-bound calls and assist customers with pharmacy-related services.
• Contact insurance companies for benefit investigation and coverage eligibility.

Skills

Attention to detail

Communication skills

Data entry

Microsoft Office

Education

High School Diploma or equivalent

Job description

Overview

As the only global provider of commercial solutions, IQVIA understands what it takes to deliver nationally and internationally. Our teams help biopharma get their medicines to the people who need them. We help customers gain insight and access to their markets and ultimately demonstrate their product’s value to payers, physicians and patients. A significant part of our business is acting as the biopharma’s sales force to physicians or providing nurses to educate patients or prescribers. With the right experience, you can help deliver medical breakthroughs in the real world.

Position Summary

AllCare Plus Pharmacy, an IQVIA company, is seeking a Care Manager. Responsibilities will vary by program and its lifecycle. Care Managers may be responsible for contacting insurance companies to obtain correct eligibility information, perform benefit investigations, copay assistance and check prior authorization and/or appeal status. Care Managers may also be responsible for directly contacting patients and/or providers to evaluate eligibility for assistance programs and/or varied adherence support. This is a remote position.

Hours

Must be available for an 8 hour shift between 8am-8pm EST

Salary

$22/hr

The information contained herein is intended to be an accurate reflection of the duties and responsibilities of the individuals assigned to this position. They are not intended to be an exhaustive list of the skills and abilities required to do the job. AllCare Plus Pharmacy reserves the right to revise the job or to require that other or different tasks be performed as assigned.

Primary Responsibilities

• Perform outbound calls to obtain appropriate information and document accurately
• Respond to in-bound calls and assist customers with pharmacy related services
• Maintain professionalism in all communication methods while providing efficient, courteous, and friendly service
• Contact insurance companies for benefit investigation and coverage eligibility
• Provide prior authorizations and appeals support
• Assist patients with the enrollment process for manufacturer and non-profit organization copay assistance programs
• Update knowledge through educational opportunities and training activities; work efficiently both individually and within a team
• Maintain and improve quality results by adhering to program standards and guidelines
• Report ADEs according to program policy and guidelines; adhere to HIPAA compliance/guidelines; may assist with onboarding new employees

Required Qualifications

• Reside in the country where the job is located
• High School Diploma or equivalent; some college preferred
• Minimum one year experience in medical billing, reimbursement, insurance verification, or related medical office experience
• Data entry experience (minimum three months) and ability to type 30 wpm+
• High attention to detail
• Computer savvy with ability to navigate multiple tabs, monitors and applications
• Advanced knowledge of Microsoft Office (Teams, Word, Excel, Outlook) and soft phone systems
• Exceptional written and verbal communication skills
• Ability to work in a virtual team environment and be available during working hours
• Strong follow-through
• Private workspace free of distraction to adhere to HIPAA compliance/guidelines
• Internet connectivity in workspace; Wi-Fi not permitted

Preferred Qualifications

• Experience in Patient Support Services (Hub)
• Healthcare-related Customer Service experience
• Bilingual

Professional Competencies

Business Skills and Knowledge

• General Management – Demonstrate analytic and problem-solving skills and understand the impact of individual decisions on other parts of the organization and the environment.
• Quality improvement – Application of techniques that continually improve the quality of care, patient safety, organizational performance, and financial health of the organization.

Knowledge of the Health Care Environment

• Health Care Systems and Organizations – Understand how the health care system is organized and financed, and how they interact to deliver care.

• The Patient’s Perspective – Understand the patient experience, rights and responsibilities, and ensure a safe environment for patients and families.

Communication and Relationship Management

• Relationship Management – Build and maintain relationships with internal and external stakeholders anchored in trust.
• Communication Skills – Use verbal, written and presentation skills to convey the organization’s mission and priorities.

• Professionalism – Align personal and organizational conduct with ethical and professional standards.

IQVIA is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.

The potential base pay range for this role is $22.00 per hour. The actual base pay offered may vary based on qualifications, location, and schedule. Incentives, bonuses, and other benefits may be offered where applicable.