paycor
Oncology Case Manager
ConnectMed360
Remote, USA
Full-time
Senior Level
Remote
USD 60000-60000 yearly
Discovered 1 weeks ago
Free
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• Medical; Dental; Vision
- 401k with a match
- Paid Time Off and Paid Holidays
- Tuition Reimbursement
- Company paid benefits – life; and short and long-term disability
- Perform benefit verification and coverage determination to identify and communicate the patient’s plan benefit coverage including the need for prior authorization, appeal, tier exception, and/or formulary exclusions
- Support the facilitation of prior authorization and appeal processes by gathering necessary clinical documentation and information, with guidance from senior team members as needed
- Screen, enroll, and educate eligible patients of free goods programs where applicable as per program business rules
- Perform patient outreach as needed to facilitate prescription fulfillment and therapy adherence as per program rules
- Comprehensively understand the benefits investigation process, insurance plans, and available patient assistance programs
- Operate both inbound and outbound calls as per the program-approved Frequently Asked Questions (FAQs), Call Guides, Call Scripts, and other program-approved material
- Field inbound calls from prescribers, patients and client’s account teams as directed by the program approved FAQs
- Inform and support patients by providing education and information throughout their therapy journey as to the status of their medication, needed processes, and connection to other stakeholders providing support like their Oncology treatment care team or pharmacy
- Assist in monitoring and maintaining the reauthorization of insurance coverage process to ensure continuity of therapy access
- Serve as primary point of contact for incoming phone calls from patients, caregivers, physicians and client's department teams. Proactively provides updates to internal and external stakeholders on patient cases in a timely manner.
- Create trusting relationships with physician offices and client department teams in their assigned region(s).
- Conduct scripted welcome calls and ongoing educational support calls to patients and office staff to introduce the program and confirm required enrollment information as necessary.
- Demonstrate an understanding of business rules, work instructions, and company-approved communications for patients and HCPs. Comprehensively understand the benefits investigation process, plan design, prior authorization criteria and processes, and all available patient support program offerings.
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