[Hiring] Dedicated Care Coordinator @Pfizer

Role Description

The Inflammation and Immunology Dedicated Care 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.

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.

How You Will Achieve It

• Case Ownership and the Patient Journey
  • 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.
  • Support access with HCPs and opted-in patients/caregivers who have been prescribed a PDPA OR VFM product.
• Benefits Investigation and Financial Navigation
  • Conduct the Summary of Benefits (SOB) discussion required for every HUB-enrolled patient.
  • 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.
  • 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.
• Appointment and Assessment Coordination
  • 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.
• Program and Copay Administration
  • Manage all Interim Care (IC) program administrative requirements and deadlines.
  • Confirm voucher need and eligibility with the provider and patient.
  • Maintain Copay portal access and help approved commercial patients secure a copay card.
  • Follow up with the patient post-fill to confirm the copay card is functioning correctly.
• Prescription Triage, Fulfillment, and Ongoing Follow-Up
  • 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.
• Case and Systems Ownership
  • Manage and update various case types in Polaris.
  • View and interpret prior authorization, appeal, and PEF documentation for accuracy.
  • Share and manage cases with HUB partners across all patient journeys.
  • Maintain case comments as a real-time account of the patient journey.
  • Use the Kite works encrypted email system for correspondence with patients and providers.
  • Manage the Docusign process with patients to obtain required consents.
• Compliance, Safety Reporting, and Communication
  • Report adverse events (AEs) in accordance with company requirements.
  • 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.
  • Conduct yourself with the utmost discretion and confidentiality.
  • Adhere to strict company compliance guidelines and procedures.

Qualifications

• B.S. or B.A. Degree
• 8+ years of pharmaceutical (or related) experience in customer-facing roles/functions.
• Experience as an FRM, PAC, ACM, FAS or working experience within access and Reimbursement.
• Demonstrated ability to communicate directly with patients, with providers, and with cross-functional colleagues.
• Proficiency conducting benefit investigation and verification directly with payers.
• Strong understanding of Reimbursement, Government Payment Systems, Specialty Pharmacy Networks, Co-Pay Assistance Programs.
• Ability to own a high volume of concurrent cases across a patient journey.

Requirements

• Experience in a Patient and/or customer facing role requiring access and reimbursement education.
• Working proficiency in Polaris, including case management and documentation.
• Experience working with a HUB.
• Experience with Kite works or a comparable encrypted email platform.
• Experience coordinating with third-party vendors on patient assessment, testing, or specialty pharmacy logistics.

Benefits

• 401(k) plan with Pfizer Matching Contributions.
• Paid vacation, holiday and personal days.
• Paid caregiver/parental and medical leave.
• Health benefits to include medical, prescription drug, dental and vision coverage.

Company Description

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.