What Individualized Care contributes to Cardinal Health
Clinical Operations is responsible for providing clinical specialties support and expertise in the areas of advice and consulting, research and patient care to internal business units and external customers.
Individualized Care provides care that is planned to meet the particular needs of an individual patient.
3-6 years of experience
High School diploma or GED preferred
Previous healthcare experience with insurance or in pharmaceutical industry, preferred
Pharmacy benefits management experience preferred with specific knowledge of Medicare, Medicaid and commercially insured payer common practices and policies, preferred
Previous prior authorization and appeals experience highly desired
Knowledge of ICD coding, preferred
Intermediate Microsoft skills with specific experience with Excel
Organized with the ability to prioritize multiple, concurrent assignments and work with a sense of urgency
Exceptional communication skills both verbally and written
Self-starter with demonstrated initiative, creativity, and a willingness to learn
Monitor system accounts for new Patient cases
Conduct customers to confirm approval/denials of coverage, co-pays, patient assistance programs and verification of specialty pharmacy that will dispensing their medication
Obtain and enter accurate benefit information to positively impact insurance processing and minimize rejections
Mediate effective resolution for complex payer/pharmacy issues toward a positive outcome to de-escalate
Assess patients for eligibility for co-pay and financial assistance
Answer requests from doctors and/or patients checking on status of case
Maintain quality while providing an empathetic and supportive experience to the patients, doctors, and physician offices
Resolve patient's questions and concerns regarding status of their request for assistance
Enter detailed information into designated CRM while communicating with doctors or patients via multiple communication channels
Steward patient accounts from initial contact through final approval/denial
Process all patient applications in accordance to set policy, procedures, and PHI compliance
Support manufacturer field team members as required on case updates
Works internally with team members regarding patients' cases
Ability to identify, document and submit Adverse Events during customer contact or via received documentation
Conduct research associated with alternative funding or foundations to ensure patient has required information to receive product
Willingness to learn
Attention to detail and high quality standards
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
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
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.
Headquartered in Dublin, Ohio, Cardinal Health, Inc. (NYSE: CAH) is a distributor of pharmaceuticals, a global manufacturer and distributor of medical and laboratory products, and a provider of performance and data solutions for healthcare facilities.We are a crucial link between the clinical and operational sides of healthcare, delivering end-to-end solutions and data-driving insights that advance healthcare and improve lives every day. With deep partnerships, diverse perspectives and innovative digital solutions, we build connections across the continuum of care. With more than 50 years of experience, we seize the opportunity to address healthcare's most complicated challenges – now, and in the future.As a global, growing company, we’re able to offer rewarding careers that let you make a positive impact on our customers and communities.