Patient Navigator, Individualized Care (Remote) Job at Cardinal Health

Cardinal Health Texas

What Individualized Care contributes to Cardinal Health

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.

Accountabilities

The Patient Navigators performing case management supports patient access to therapy in accordance with the program business rules. This position is responsible for guiding the patient and healthcare provider through the various process steps of their patient journey to therapy. These steps include relaying benefit information to both patient and healthcare providers, conducting patient welcome calls and follow up calls to assist patients, patient caregivers and healthcare providers, as well as assist with any prior authorizations or appeals to facilitate coverage and dispense of product in a timely manner.

  • Deliver virtual or telephonic educational support to identified patients, caregivers, Healthcare Professionals (HCPs) and their staff to meet all relevant standards as set by the client company
  • Be a champion for each patient and consented care partner(s)
  • Answer inbound inquiries of patients, care partners and HCPs
  • Act as primary point of contact for patients and HCPs
  • Understand a patient’s support needs and interaction preferences to deliver a seamless, tailored patient experience that helps each patient complete their pathway to treatment as prescribed by their HCP
  • Establish an ongoing relationship with each assigned patient, starting with Welcome, onboarding, treatment initiation, continuation, and ongoing interactions
  • Provide support and guidance to help ensure patients have access to the patient support program resources by compliantly navigating reimbursement, and mitigating any patient out-of-pocket barriers, as applicable
  • Experience in supporting time sensitive requests and prioritization of assignments and working with a sense of urgency.
  • Investigate and resolve patient/healthcare provider inquiries and concerns in a timely mannerdors to clearly identify issues and provide resolution.
  • Work closely with patients, patient caregivers, healthcare providers. Sonexus Health reimbursement team, the manufacturer’s employees, third party ven
  • Responsible for meeting the newly identified patient, patient caregivers, healthcare providers over the phone to provide education on the drug, disease process, diagnostic testing, support services provided by the manufacturer and review benefit information.
  • Patient Navigators work closely with the Case Managers to coordinate care and educational opportunities for patients, patient caregivers, and healthcare providers regarding the patient journey.
  • Support healthcare providers with Prior Authorization and Appeals submission to Insurance carrier.
  • Exhibit effective communication and tele-management skills.
  • Proactive follow-up with various contacts to ensure patient access to therapy.
  • Converse with callers in an empathetic manner and build rapport
  • Act as patient and healthcare providers single point of contact for all inquiries
  • Possess effective organizational skills, including working on multiple cases simultaneously.
  • Responsible for the identification, intake, documentation, and submission of all Adverse Event Reports occurring in patients which are taking or have previously taken the manufacturer’s product.
  • Submit all adverse event reports to manufacturer/third party vendor within stipulated timeframe; additionally follow up if requested to do so.
  • Responsible for addressing Medical Information inquiries from consumers, healthcare providers and other entities, including but not limited to, requests for product information, inquiries about side effects, guidelines for appropriate use of the product, etc.
  • Provide identification, intake, documentation, and submission of all reported Product Complaints, per the manufacturer guidelines.
  • Perform other activities related to the internal initiatives and/or the manufacturer’s programs as assigned.
  • Responsible for maintaining HIPAA guidelines.
  • Must adhere to strict guidelines regarding the protection of proprietary educational materials and product information that may be printed or available via email, websites, or other electronic means, provided by the manufacturer.
  • Concurrently handle multiple outstanding issues and ensure all items are resolved in a timely manner to the satisfaction of all parties

Qualifications

  • Bachelor's Degree Preferred
  • Previous social work experience is preferred
  • LVN is preferred
  • 2-4 years of Case Management experience is required
  • Demonstrate effective, empathetic and professional communication
  • Clear knowledge of Medicare (A, B, C, D)
  • 1-2 years of Pharmacy and/or Medical Claims billing and Coding work experience is preferred
  • 1-2 years of experience with Prior Authorization and Appeal submissions
  • Must be able to manage multiple concurrent assignments
  • Must communicate clearly and effectively in both a written and verbal format
  • Ability to work with high volume production teams with an emphasis on quality
  • Able to thrive in a competitive and dynamic environment
  • 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
  • Bilingual (Spanish) is a plus

Key Characteristics

  • Compassionate and caring
  • Patient and attentive listener
  • Adaptable and Flexible
  • Self-Motivated and Dependable
  • Problem Solving
  • Strong patient support skills and professional experience working with medical providers
  • Team Spirited
  • Punctual and Efficient
  • Great work attitude

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-Saturday, 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

#LI-Remote

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.




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