Sr. Care Manager
As the only global provider of commercial solutions, IQVIA understands what it takes to deliver nationally and internationally. Our teams help biopharma get their medicines to the people who need them. We help customers gain insight and access to their markets and ultimately demonstrate their product’s value to payers, physicians and patients. A significant part of our business is acting as the biopharma’s sales force to physicians or providing nurses to educate patients or prescribers. With the right experience, you can help deliver medical breakthroughs in the real world.
AllCare Plus Pharmacy, an IQVIA company, is seeking a Care Manager! Responsibilities will vary by program and its lifecycle. Care Manager’s may be responsible for contacting insurance companies to obtain correct eligibility information, perform benefit investigations, copay assistance and check prior authorization and/or appeal status. Care managers may also be responsible for directly contacting patients and/or providers to evaluate eligibility for assistance programs and/or varied adherence support. This is a remote position.
Hours: Must be available between 8am-8pm EST
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.
- Perform outbound calls to obtain appropriate information and document accurately
- Responsible for answering in-bound calls and assisting customers with pharmacy related services
- Maintain strict professionalism in all communication methods while providing efficient, courteous, and friendly service
- Contact insurance companies for benefit investigation and coverage eligibility
- Provide prior authorizations and appeals support
- Assist patients with the enrollment process for manufacturer and non-profit organization copay assistance programs
- 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 by meeting quality standards set forth by program KPI’s
- Report ADE’s according to program policy and guidelines Adhere to all HIPAA guidelines May assist with onboarding new employees
- High School Diploma or equivalent, some college preferred
- Minimum one year experience in medical billing, insurance verification, or similar related medical office experience
- Previous data entry experience (minimum three months) and ability to type 30wpm+
- Able to demonstrate high attention to detail in work
- Must be computer savvy, to include navigating multiple computer tabs, monitors and applications
- Advanced ability/knowledge of all Microsoft Suite programs (Teams, Word, Excel, Outlook, etc) and soft phone systems (WebEx, Mitel, Shoretel, etc.)
- Exceptional communication skills, both written and verbal
- Able to work in a virtual team environment by being available and responsive during working hours
- Excellent follow through This is a remote position.
- Employees must have a private workspace free of distraction to adhere to HIPAA compliance/guidelines.
- Workspace must include internet plug-in accessibility. Wi-fi connectivity is not permitted.
- Previous experience in Patient Support Services (Hub)
- Previous Customer Service experience in the healthcare field
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 care.
- 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.
- Professionalism – 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-statusThe potential base pay range for this role, when annualized, is $44,600.00 - $66,800.00. The actual base pay offered may vary based on a number of factors including job-related qualifications such as knowledge, skills, education, and experience; location; and/or schedule (full or part-time). Dependent on the position offered, incentive plans, bonuses, and/or other forms of compensation may be offered, in addition to a range of health and welfare and/or other benefits.