Cardinal Health Senior Coordinator, Individualized Care (Case Manager) in Lewisville, Texas

What Individualized Care contributes to Cardinal Health

Delivering 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.

What is expected of you and others at this level

  • Effectively 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

Accountabilities

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 patient through the various process steps of their patient journey to therapy. These steps include patient referral intake, investigating all patient health insurance benefits, and proactively following up with various partners including the insurance payers, specialty pharmacies, support organizations, and the patient/physician to facilitate coverage and delivery of product in a timely manner.

  • Investigate and resolve patient/physician inquiries and concerns in a timely manner
  • Mediate 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
  • Demonstrate superior customer support talents
  • Prioritize multiple, concurrent assignments and work with a sense of urgency
  • Must communicate clearly and effectively in both a written and verbal format

Qualifications

  • Previous customer service experience, preferred
  • High School diploma or equivalent, preferred
  • Experience conducting and documenting patient health insurance benefit investigations, prior authorizations, and appeals, preferred (1-2 years)
  • 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 is preferred
  • Important to have a strong attention to detail
  • The work hours for this position is 10am-7pm

Cardinal 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.