Clinical Care Coordinator (Plano)

Our client is looking for a full-time Care Coordinator (CC) to join their team in Plano, Texas .

The Care Coordinator is responsible for customer service and case coordination. This position will help plan members access financial assistance programs. The Care Coordinator will follow up with members, pharmacies, health care providers and / or financial assistance programs to confirm shipment / receipt of drug shipments. From time to time, the Clinical Care Coordinator will be in contact with PBMs and Payers (Funds, Plan Sponsors, Insurers) to gather information and assist plan members to connect members with alternative medication funding who have complex clinical conditions and are receiving medication in a home infusion or in-office infusion setting.

Responsibilities :

• Ensure that plan members meet plan eligibility requirements
• Act as primary point of contact for plan members
• Serve as plan member advocate and enhance the collaborative relationship between the plan member, health care provider, and patient assistance program representatives
• Document / record all interactions with members, health care providers, pharmacies, and financial assistance entities in the Customer Relationship Manager software (CRM) in a timely manner
• Provide exceptional customer service to internal and external customers; resolve any customer requests in a timely and accurate manner; escalates complaints accordingly
• Review pending activities / events and specific customer requests to ensure excellent customer service and customer experience
• Demonstrate proficiency and full understanding of the Company plan member database including data elements, definition of case statuses and outcomes, case documentation requirements and the importance of meeting company metrics
• Research and identify available financial assistance programs for specialty drugs that are prescribed for active members
• Coordinate access to patient assistance programs; provide assistance to plan members and physician staff to complete all necessary financial assistance program forms and applications in a timely manner
• Coordinate delivery and verify receipt of financial assistance forms and applications to plan members, physician offices, and financial assistance programs
• Verify drug dispenses to members and compile audit trail of source documents and information for each dispense
• Report any financial assistance program trends to supervisor
• Communicate with plan members health plan sponsor, Fund, or PBM as needed
• Recommend improved processes and management methods to generate workflow optimization
• Perform such other duties as needed or assigned by management.

Requirements :

Preferred skills

If this sounds like you, please contact us today!

Unable to sponsor visas for this position. Please encourage those authorized, to work in the U.S. without a visa, to apply!

Must be authorized to work in the U.S.!