Care Coordinator – Oncology

Job Description:

• Own patient cases from initiation to closure
• Conduct benefit investigations and prior authorizations/denial appeals
• Determine financial qualifications for assistance programs
• Assist patients, callers, and stakeholders through resolution via email, inbound/outbound calls, and Lynk technology
• Build trusted relationships with patients, prescribers, and client stakeholders
• Perform program welcome calls and post-benefits-investigation calls
• Explain coverage options to patients and physicians
• Manage client and HCP inquiries according to business rules
• Manage inbound calls using program-approved FAQs
• Triage patients to internal or external resources
• Provide personalized case management and communicate benefit coverage and next steps
• Identify payer coverage and complete manual benefit investigations as needed
• Communicate prior authorization, appeal, tier exception, and formulary exclusion requirements
• Follow up with payers and HCPs on submissions and outcomes
• Coordinate nurse education and follow-up services
• Identify peer support resources
• Coordinate product shipment through patient assistance and bridge programs
• Communicate prior authorization reverification and patient assistance re-enrollment needs
• Report adverse events, product complaints, special situation reports, and medical inquiries according to SOPs
• Document activities in the PharmaCord Lynk system
• Follow corporate policies, SOPs, and training deadlines
• Perform additional assigned tasks and projects

Requirements:

• Bachelor’s degree strongly preferred or equivalent experience required
• Customer service and healthcare industry experience preferred but not required
• Ability to work an 8.5-hour shift between 8 am and 9 pm, Monday to Friday
• Basic computer knowledge
• Ability to multitask effectively
• Clear and concise communication
• Professional telephone etiquette
• Detail oriented
• Ability to type at least 35 words per minute with 97% accuracy preferred
• Flexibility to travel as needed preferred
• Spanish and English bilingual skills are a plus
• Successful completion of a background check and, depending on the position, a drug screen
• Remote work eligibility subject to all work-from-home criteria and business need

Benefits:

• Medical, dental, and vision plans, including HSA- and FSA-eligible options, with Valeris contributing toward premium costs
• Telehealth and Employee Assistance Program (EAP) services
• Company match on Health Savings Account contributions
• Free Basic Life and AD&D coverage equal to annual earnings, with a minimum of $50,000 and a maximum of $300,000
• Company-paid Short-Term Disability coverage, with the option to purchase Long-Term Disability
• 401(k) Retirement Savings Plan with 100% match on the first 5% contributed, with immediate vesting
• Paid Time Off (PTO) and Sick Leave
• Nine paid holidays plus two floating holidays
• Opportunities for advancement and personal and professional growth
• Challenging, stimulating work environment that encourages new ideas
• Inclusive workplace and mission-driven culture
• Remote work eligibility subject to work-from-home criteria and business need

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