[Hiring] Senior Coordinator, Individualized Care @Cardinal Health

Role Description

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 healthcare providers through the various process steps in support of their patient’s journey to therapy. These steps include:

• Patient referral intake
• Investigating all patient health insurance benefits
• Identifying & initiating prior authorization and step therapy reviews
• Proactively following up with various partners including the insurance payers, specialty pharmacies, and support organizations to facilitate coverage and delivery of product in a timely manner

Must demonstrate:

• Efficiency and strong organizational skills
• Effective resolution for complex payer/pharmacy issues toward a positive outcome to de-escalate
• Proactive follow-up with various contacts to ensure patient access to therapy
• Superior customer support talents that remain in compliance with standard call quality expectations
• Clear and effective communication in both written and verbal format
• Ability to meet daily task and benefit investigation goals associated with a high enrollment volume/low patient interaction program

Qualifications

• High School Diploma, GED, or equivalent work experience
• 3-6 years experience in related field preferred
• 1-2 years experience conducting and documenting patient health insurance benefit investigations, prior authorizations, and appeals preferred
• Knowledge of Medicare, Medicaid and Commercially insured payer common practices and policies preferred
• Critical and creative thinking preferred
• Knowledge of the Health Insurance Market Place and the Affordable Care Act preferred
• Knowledge of Medical/Pharmacy billing and coding preferred
• Strong attention to detail

Requirements

• 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 shift schedules during our normal business hours of Monday-Friday, 7:00am-7:00pm CT
• Anticipated hourly range: $21.40 per hour - $30.60 per hour
• Bonus eligible: No

Benefits

• Medical, dental and vision coverage
• Paid time off plan
• Health savings account (HSA)
• 401k savings plan
• Access to wages before payday with myFlexPay
• Flexible spending accounts (FSAs)
• Short- and long-term disability coverage
• Work-Life resources
• Paid parental leave
• Healthy lifestyle programs

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:

• 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