Care Managers are responsible for following specific program workflows to include contacting insurance companies to obtain correct eligibility information, perform benefit investigations, provide copay assistance and check prior authorization and/or appeal statuses.
The information contained herein is intended to be an accurate reflection of the duties and responsibilities of the individuals assigned to this position. They are not intended to be an exhaustive list of the skills and abilities required to do the job. AllCare Plus Pharmacy reserves the right to revise the job or to require that other or different tasks be performed as assigned.
Responsible for answering in-bound calls and assisting customers with dedicated client related services Contact insurance companies to perform appropriate benefit investigation(s) and coverage eligibility for client product only If applicable, assist with the completion of the prior authorizations with attention to detail and accuracy with provided information. Assist patients with the enrollment process for manufacturer and non-profit organization copay assistance programs Provide customers with courteous, friendly, fast and efficient service Update job knowledge by participating in educational opportunities and training activities. Work efficiently both individually and within a team to accomplish required tasks Maintain and improve quality results by adhering to standards and guidelines and recommending improved procedures
High School Diploma or equivalent, some college preferred Minimum one year experience in pharmacy, medical billing, insurance verification, or similar related healthcare experience Previous data entry experience (minimum three months) and ability to type 30wpm+
Customer Service experience Healthcare experience Flexible work schedule Bilingual (Spanish) highly desirable Ability to use MS Office
Business Skills and Knowledge
- General Management
Demonstrate analytic and problem solving skills, and understand the impact of individual
decisions on other parts of the organization and the environment.
- Quality improvement
Application of techniques that continually improve the quality of care provided, patient
safety, organizational performance, and the financial health of the organization.
Knowledge of the Health Care Environment
- Health Care Systems and Organizations
Demonstrate an understanding of how the various components of the health care
system is organized and financed, and how they interact to deliver medical and health
- The Patient’s Perspective
Understand the patient experience, demonstrate a commitment to patients’ rights and
responsibilities, and ensure that the organization provides a safe environment for
patients and their families.
Communication and Relationship Management
- Relationship Management
The ability to build and maintain relationships with internal as well as external
stakeholders that are anchored in trust and where decision-making is shared.
- Communication Skills
Be able to utilize verbal, written and presentation skills to communicate an
organization’s mission, vision, values and priorities to diverse audiences.
- The ability to align personal and organizational conduct with ethical and professional standards
that include a responsibility to the patient and community, a service orientation, and a
commitment to lifelong learning and improvement.
IQVIA is a leading global provider of advanced analytics, technology solutions and clinical research services to the life sciences industry. We believe in pushing the boundaries of human science and data science to make the biggest impact possible – to help our customers create a healthier world. Learn more at https://jobs.iqvia.com
We are committed to providing equal employment opportunities for all, including veterans and candidates with disabilities. https://jobs.iqvia.com/eoe
IQVIA’s ability to operate and provide certain services to customers and partners necessitates IQVIA and its employees meet specific requirements regarding COVID-19 vaccination status. https://jobs.iqvia.com/covid-19-vaccine-status