Access and Patient Support: Case Manager

Cardinal Health Sonexusu2122 Access and Patient Support helps specialty pharmaceutical manufacturers remove barriers to care so that patients can access, afford and remain on the therapy they need for a better quality of life. Our diverse expertise in pharma, payer and hub services allows us to deliver best-in-class solutionsu2014driving brand and patient markers of success. Weu2019re continuously integrating advanced and emerging technologies to streamline patient onboarding, qualification and adherence. Our non-commercial specialty pharmacy is centralized at our custom-designed facility outside of Dallas, Texas, empowering manufacturers to rethink the reach and impact of their products. Responsibilities: Patient Access & Advocacy u00b7 Support patient access to therapy through Reimbursement Support Services and patient support programs, in accordance with business rules and HIPAA regulations. u00b7 Guide patients and healthcare providers through all steps of the patient journey, including referral intake, benefit investigation (pharmacy and medical), prior authorization, and therapy delivery. u00b7 Actively advocate for patients by navigating complex healthcare systems, addressing concerns, and securing necessary approvals for treatments and medications. u00b7 Assess patient financial ability and provide guidance to appropriate financial assistance programs. u00b7 Implement strategies to promote medication adherence, including patient education, regular check-ins, and addressing barriers to compliance. u00b7 Evaluate patient eligibility for assistance programs and assist with enrollment. Care Coordination & Insurance Navigation u00b7 Manage the entire care process from benefit investigation/verification to medication delivery, ensuring an exceptional patient experience. u00b7 Conduct benefit verifications and collaborate with physicians, pharmacies, and insurance companies for seamless coordination and timely access to services. u00b7 Help patients understand insurance coverage, out-of-pocket costs, and appeals processes. u00b7 Assist in obtaining insurance, prior authorization, and appeal requirements and outcomes. u00b7 Remain knowledgeable about changes in the reimbursement environment (Medicare, Medicaid, Managed Care, Commercial plans). Program Expertise & Continuous Improvement u00b7 Remain updated on available patient resources and oversee systems and procedures for accuracy and efficiency. u00b7 Demonstrate deep understanding of the patient support program and contribute to its continuous improvement. u00b7 Track key patient metrics, analyze data for trends and improvement opportunities, and generate reports for stakeholders. u00b7 Anticipate potential problems, refer to policies and past practices, and develop effective solutions. u00b7 Provide guidance and training to junior case managers on best practices. Communication & Collaboration u00b7 Provide world-class service, striving for one-call resolution for inbound calls from patients, healthcare provider offices, specialty pharmacies, and customers. u00b7 Mediate effective resolution for complex payer/pharmacy issues and de-escalate situations. u00b7 Collaborate with internal and external teams, focusing on problem-solving and teamwork. u00b7 Build and maintain professional relationships with all stakeholders, including case management, patient support services, medical, sales, market access, insurance companies, specialty pharmacies, and office coordinators. u00b7 Display high emotional intelligence and professional communication to foster strong working relationships. Documentation & Compliance u00b7 Maintain accurate and detailed notations for every interaction using the appropriate database/CRM. u00b7 Document and share reimbursement and other knowledge with team members. u00b7 Ensure compliance with company and manufacturer policies. u00b7 Track payer/plan issues and report changes, updates, or trends to management. u00b7 Handle escalations and ensure proper communication of resolutions within required timeframes. Other Duties u00b7 Provide caseload coverage outside of assigned duties/territory as needed. u00b7 Make outbound calls for patient follow-ups or confirmations. u00b7 Proactively follow up with partners to facilitate coverage and timely product delivery. u00b7 Cultivate innovation by monitoring systems, processes, and care gaps, offering new ideas and solutions. Qualifications u00b7 High School Diploma, GED, or technical certification required; college degree preferred. u00b7 3u20138 years of industry experience with patient-facing or high-touch customer interaction experience, preferred. u00b7 In-depth understanding of health insurance benefits, relevant state and federal laws, and insurance regulations. u00b7 Strong understanding of pharmaceutical therapies, disease states, and medication adherence challenges. u00b7 Excellent written and oral communication, mediation, and problem-solving skills. u00b7 Experience managing complex patient cases, preferably with specialty medications. u00b7 Robust computer literacy, including data entry and MS Office-based software programs. u00b7 Ability to work independently, prioritize effectively, and thrive in a fast-paced, dynamic environment. u00b7 Strong people skills: flexibility, persistence, creativity, empathy, and trust. u00b7 Bilingual (Spanish) skills preferred. Work Schedule & Remote Details u00b7 Full-time (40 hours/week). u00b7 Flexibility to work any shift during normal business hours: Mondayu2013Friday, 7:00amu20137:00pm CT/CST. u00b7 Mandatory new hire training: 8:00amu20135:00pm CT/CST. u00b7 Remote work requires a dedicated, quiet, private, distraction-free environment with high-speed internet (DSL, Cable, or Fiber; dial-up, satellite, WiFi, cellular not acceptable). u00b7 Download speed: 15Mbps; Upload speed: 5Mbps; Ping rate: max 30ms; hardwired to router; surge protector with network line protection for company-issued equipment. These responsibilities provide an overview of the position and may be adjusted according to business requirements. The organization reserves the right to modify duties, reporting structure, or assign additional tasks as needed. This job description is subject to revision at any time. Anticipated hourly range: $21.50 per hour - $30.70 per hour Bonus eligible: No Benefits: Cardinal Health offers a wide variety of benefits and programs to support health and well-being. + Medical, dental and vision coverage + Paid time off plan + Health savings account (HSA) + 401k savings plan + Access to wages before pay day with myFlexPay + Flexible spending accounts (FSAs) + Short- and long-term disability coverage + Work-Life resources + Paid parental leave + Healthy lifestyle programs Application window anticipated to close: 12/26/2025 if interested in opportunity, please submit application as soon as possible. The hourly range listed is an estimate. Pay at Cardinal Health is determined by multiple factors including, but not limited to, a candidateu2019s geographical location, relevant education, experience and skills and an evaluation of internal pay equity. _Candidates who are back-to-work, people with disabilities, without a college degree, and Veterans are encouraged to apply._ _Cardinal Health supports an inclusive workplace that values diversity of thought, experience and background. We celebrate the power of our differences to create better solutions for our customers by ensuring employees can be their authentic selves each day. 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_ here (

Created: 2025-11-01