Care Coordinator
Accountabilities: As a Care Coordinator, you will support the patient services team by managing reimbursement activities, educating healthcare providers, and coordinating access solutions. You will play a critical role in ensuring patients receive appropriate support while maintaining compliance, operational excellence, and strong stakeholder relationships.
Engage with healthcare providers and office staff through multiple communication channels to answer questions and provide guidance on product coverage and reimbursement requirements.
Support the complete reimbursement journey, including patient enrollment, access determination, prior authorization processes, appeals, denials, and financial assistance requirements.
Educate healthcare providers and staff on patient assistance programs and access pathways.
Serve as a payer and pharmacy resource for assigned territories or accounts, communicating changes and access updates to key stakeholders.
Monitor payer requirements, coverage policies, and market access trends to identify opportunities and barriers affecting patient access.
Partner with internal teams and external stakeholders to support patient access strategies and improve therapy adoption.
Maintain strong knowledge of specialty pharmacy channels, hub services, insurance benefits, and reimbursement processes.
Analyze territory data, reports, and performance metrics to identify trends and support strategic decision-making.
Track and achieve program service-level agreements (SLAs), key performance indicators (KPIs), and operational goals.
Manage changing priorities, market dynamics, and account complexities while maintaining high service standards.
Capture customer insights through effective communication, research, and problem-solving to support program improvements.
Maintain accurate documentation across CRM and reporting systems while following ethical, legal, and compliance requirements.
Requirements:
The successful candidate will bring experience in healthcare reimbursement, patient support services, and stakeholder engagement. This role requires strong analytical abilities, communication skills, and the ability to independently manage complex patient access processes.
Bachelor’s degree or advanced degree preferred.
Minimum of 3 years of experience in healthcare reimbursement, pharmaceutical services, managed care, clinical support, or related fields.
Experience supporting specialty pharmacy, patient services, hub programs, or healthcare provider relationships preferred.
Strong understanding of health insurance benefits, including Medicare Part D, commercial insurance, Medicaid, prior authorizations, appeals, reimbursement coverage, and patient assistance programs.
Knowledge of specialty product access challenges and strategies for removing reimbursement barriers.
Familiarity with Centers for Medicare & Medicaid Services (CMS) policies and Medicare Part D processes is a plus.
Understanding of managed care, government payer sectors, and integrated healthcare systems preferred.
Strong proficiency with Microsoft Office tools, including Excel and reporting platforms such as Tableau.
Experience using complex patient access CRM systems such as Salesforce, Veeva, or similar platforms.
Advanced research, analytical, problem-solving, and critical-thinking skills.
Strong written and verbal communication skills with excellent attention to detail.
Ability to manage multiple priorities independently in a remote environment.
Customer service experience, particularly in healthcare or call center environments, preferred.
Strong collaboration skills with the ability to work effectively across internal and external teams.
Willingness and ability to travel occasionally (less than 10%) based on business needs.
Benefits:
The role offers competitive compensation and benefits designed to support employee well-being, professional growth, and work-life balance.
Hourly compensation range of $24 to $29 per hour.
Fully remote work environment with territory-based support responsibilities.
Full-time schedule with Monday–Friday operating hours.
Medical, dental, and vision benefits.
Opportunities to support meaningful healthcare initiatives and improve patient outcomes.
Collaborative work environment with healthcare professionals and cross-functional teams.
Professional development opportunities.
Paid time off and additional employee benefits.
How Jobgether works: We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team. We appreciate your interest and wish you the best! Why Apply Through Jobgether?
Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.
#LI-CL1