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Job Description: Case ManagerWhat Individualized Care contributes to Cardinal HealthDelivering an exclusive model that fully integrates direct drug distribution to site-of-care with non-commercial pharmacy services, patient access support, and financial programs, Sonexus Health, a subsidiary of Cardinal Health, helps specialty pharmaceutical manufacturers have a greater connection to the customer experience and better control of product success. Personalized service and creative solutions executed through a flexible technology platform means providers are more confident in prescribing drugs, patients can more quickly obtain and complete therapy, and manufacturers can directly access more actionable insight than ever before. With all services centralized in our custom-designed facility outside of Dallas, Texas, Sonexus Health helps manufacturers rethink how far their products can go.AccountabilitiesMonitor system accounts for new Patient cases
Conduct outbound calls to patients to confirm approval/denials of coverage, co-pays and verification of specialty pharmacy that will dispensing their medication
Contact insurance companies as required to obtain and enter accurate benefit information to positively impact insurance processing and minimize rejections
Mediate effective resolution for complex payer/pharmacy issues toward a positive outcome to de-escalate
Place outbound calls to patients to assess for eligibility for co-pay and financial assistance
Answer minimal inbound calls from doctors and/or patients checking on status of case
Maintain quality while providing an empathetic and supportive experience to the patients, providers, and physician offices
Resolve patient's questions and concerns regarding status of their request for assistance
Enter detailed information into company proprietary software while conversing via telephone
Steward patient accounts from initial contact through final approval/denial
Process all patient applications in accordance to set policy, procedures and PHI compliance
Speak with manufacturer field team members on case updates via phone or by email
Works internally with team members regarding patients’ cases
Ability to identify, document and submit Adverse Events during customer contact or via received documentation
Conduct research associated with alternative funding or foundations to ensure patient has required information to receive product
QualificationsMinimum of HS diploma; additional education preferred
Previous healthcare experience with insurance or in pharmaceutical industry, preferred
Pharmacy benefits management experience preferred with specific knowledge of Medicare, Medicaid and commercially insured payer common practices and policies, preferred
Previous prior authorization and appeals experience highly desired
Knowledge of ICD coding, preferred
Intermediate Microsoft skills with specific experience with Excel
Organized with the ability to prioritize multiple, concurrent assignments and work with a sense of urgency
Exceptional communication skills both verbally and written
Self-starter with demonstrated initiative, creativity and a willingness to learn
Desired Attributes:Willingness to learn
Self-starter
Quality
Attention to detail
Adaptable
Focus
Organized
Anticipating any issues
Detailed
Attentiveness
Compassionate
Empathy
What is expected of you and others at this levelEffectively 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
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.To read and review this privacy notice click hereCardinal Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.
