Care Coordinator (Oncology)

Key Responsibilities

• Builds trusted relationships with patients, prescribers, client stakeholders through proactive communication, timely and accurate execution of deliverables and demonstrated relentless passion for helping patients
• Manages all relationships in a manner that adheres to healthcare laws and regulations
• Performs program welcome calls to patients
• Performs post Benefits Investigation calls to patients and physicians explaining coverage options
• Manages all client inquiries unable to be determined by client through reporting
• Manages HCP inquiries, as applicable, pursuant to business rules
• Manages inbound calls as directed by the program-approved FAQs
• Triage patients to internal or external resources as appropriate
• Provides personalized case management to patients and HCPs including outbound communication to HCPs and patients to communicate benefit coverage and next steps in obtaining coverage
• Leverages electronic tools to identify benefits and payer coverage; completes manual benefit investigation as needed
• Identifies and communicates patient’s plan benefit coverage including the need for prior authorization, appeal, tier exception, and/or formulary exclusions
• Uses electronic resources to obtain benefit coverage outcome and if needed, outbound call to payers and HCPs to follow up on proper submission and/or outcome
• Coordinates nurse teach with field-based nurse educators, as applicable to program
• Supports adherence services through coordination of nurse follow up, as applicable to program
• Identifies peer support resources for patients
• Coordinates shipment of product through patient assistance program and/or bridge program from the PharmaCord pharmacy
• Proactively communicates needs for reverification of prior authorization or re-enrollment for patient assistance program
• Reports adverse events, Product complaints, special situation reports and/or medical inquiries received in accordance with SOPs and the Business Rules
• Documents all activities within the PharmaCord Lynk system in accordance with business requirements
• Utilize Valeris’ values as the driving force behind the team’s success
• On time adherence to training deadlines for all corporate policies and procedures
• Ensure all SOPs are followed with consistency
• Perform additional tasks or projects as assigned

Qualifications

• Detail oriented
• Professional telephone etiquette
• Self-awareness of your own emotions and the potential impact on others
• Basic computer knowledge
• Ability to multitask effectively
• Ability to recognize emotions and their effects
• Sureness about self-worth and capabilities
• Manage disruptive impulses
• Maintain standards of honesty and integrity
• Takes responsibility for performance
• Adapts and handles change with flexibility
• Is innovative and open to new ideas
• Achievement driven; constant striving to improve or to meet a standard of excellence
• Aligns with the goals of the group or organization
• Ready to take initiative and act on opportunities
• Be optimistic and pursue goals persistently despite obstacles and setbacks
• Be service oriented and anticipate, recognize and meet needs of others, including patients and care partners
• Clear and concise communication
• Positive attitude!

Bachelor’s degree strongly preferred or equivalent experience required. Customer service and healthcare industry experience is preferred but not required. Ability to work an 8.5-hour shift between 8 am to 9 pm, Monday to Friday required. Bi-lingual skills in Spanish and English are a plus. Remote work eligibility is subject to all work from home criteria met and based on business need.

Physical Demands & Work Environment

While performing the duties of this job, the employee is regularly required to talk or hear. The employee is frequently required to sit for long periods of time, use hands to type, handle or feel; and reach with hands and arms. Prefer candidates who can type at least 35 words per minute with 97% accuracy. Although very minimal, flexibility to travel as needed is preferred. This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, etc.