Case manager Jobs in Cary, NC

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.

• Responsibilities_

First point of contact on inbound calls and determines needs and handles accordingly

Creates and completes accurate applications for enrollment with a sense of urgency

Scrutinizes forms and supporting documentation thoroughly for any missing information or new information to be added to the database

Conducts outbound correspondence when necessary to help support the needs of the patient and / or program

Resolve patient's questions and any representative for the patients concerns regarding status of their request for assistance

Update internal treatment plan statuses and external pharmacy treatment statuses

Maintain accurate and detailed notations for every interaction using the appropriate database for the inquiry

Self-audit intake activities to ensure accuracy and efficiency for the program

Make all outbound calls to patient and / or provider to discuss any missing information and / or benefit related information

Notify patients, physicians, practitioners, and or clinics of any financial responsibility of services provided as applicable

Assess patients financial ability to afford therapy and provide hand on guidance to appropriate financial assistance

Follow through on all benefit investigation rejections, including Prior Authorizations, Appeals, etc. All avenues to obtain coverage for the product must be fully exhausted

Track any payer / plan issues and report any changes, updates, or trends to management

Search insurance options and explain various programs to the patient while helping them to select the best coverage option for their situation

Handle all escalations based upon region and ensure proper communication of the resolution within required time frame agreed upon by the client

Serve as a liaison between client sales force and applicable party

Mediate situations in which parties are in disagreement and facilitate a positive outcome

Concurrently handle multiple outstanding issues and ensure all items are resolved in a timely manner to the satisfaction of all parties

Responsible for reporting any payer issues by region with the appropriate team

As needed conduct research associated with issues regarding the payer, physicians office, and pharmacy to resolve issues swiftly

• 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

• Qualifications_

Previous customer service experience is preferred

High School diploma or equivalent preferred

Patient Support Service experience, preferred

Clear knowledge of Medicare (A, B, C, D), Medicaid & Commercial payers policies and guidelines for coverage, preferred

Knowledge of DME, MAC practices if preferred

Clear understanding of Medical, Supplemental, and pharmacy insurance benefit practices, preferred

1-2 years of Pharmacy and / or Medical Claims billing and Coding work experience

1-2 years experience with Prior Authorization and Appeal submissions

Ability to work with high volume production teams with an emphasis on quality

Intermediate to advanced computer skills and proficiency in Microsoft Office including but not limited to Word, Outlook and preferred Excel capabilities

Previous medical experience is preferred

Adaptable and Flexible, preferred

Self-Motivated and Dependable, preferred

Strong ability to problem solve, preferred

Bilingual is preferred

TRAINING AND WORK SCHEDULES : Your new hire training will take place 8 : 00am-5 : 00pm CST, mandatory attendance is required.

This position is full-time (40 hours / week). Employees are required to have flexibility to work any of our shift schedules during our normal business hours of Monday-Friday, 7 : 00am- 7 : 00pm CST.

REMOTE DETAILS : You will work remotely, full-time. It will require a dedicated, quiet, private, distraction free environment with access to high-speed internet. We will provide you with the computer, technology and equipment needed to successfully perform your job. You will be responsible for providing high-speed internet. Internet requirements include the following :

Maintain a secure, high-speed, broadband internet connection (DSL, Cable, or Fiber) at the remote location. Dial-up, satellite, WIFI, Cellular connections are NOT acceptable.

Download speed of 15Mbps (megabyte per second)

Upload speed of 5Mbps (megabyte per second)

Ping Rate Maximum of 30ms (milliseconds)

Hardwired to the router

Surge protector with Network Line Protection for CAH issued equipment

• Anticipated hourly range :
• 21.50 per hour - $30.65 per hour
• Bonus eligible :
• 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 :
• 11 / 22 / 2024
• 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 candidates 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 (https : / / www.cardinalhealth.com / content / dam / corp / email / documents / corp / cardinal-health-online-application-privacy-policy.pdf)