Overview Location: Jeffersonville, IN
Remote Status: Remote
Job Id: 776
# of Openings: 0
Executive Case Manager role with PharmaCord offers the opportunity to support patients navigating access to complex medications. The position focuses on delivering accurate, patient-centric service, ensuring timely management of prescriptions and related records, and translating program knowledge into patient-friendly guidance.
This is a hybrid/remote eligible role. Candidates may be eligible for hybrid (50% in office, 50% remote) after training (training typically lasts about 90 days). Remote work eligibility requires residing in IN/KY and successful completion of training, good performance, attendance, and adherence to KPI targets as outlined in program rules. Remote eligibility is subject to all work-from-home criteria and business needs.
Responsibilities Relationship Management: Build trusted relationships with patients, prescribers, and client stakeholders regarding reimbursement inquiries and challenges through proactive communication and accurate delivery of services.
Compliance and communications: Adhere to laws, regulations, and program procedures (HIPAA and insurance guidelines). Manage inbound/outbound calls to patients, caregivers, and healthcare professionals; triage and respond to inquiries; document activities in the Lynk system.
Personalized Case Management: Provide outbound communications to HCPs, pharmacies, and patients to communicate benefit coverage and drive next steps for coverage and access; identify and communicate plan benefits, prior authorization needs, appeals, and formulary considerations.
Education and advocacy: Serve as a subject matter expert, educate patients and healthcare professionals on program tools, Payor processes, and eligibility.
Operational duties: Complete benefits investigations, track prior authorizations/denial appeals, generate reports, and support adherence and nurse-teaching activities as applicable.
Documentation: Maintain detailed records of reimbursement activities, including claims status, payments, and appeals, in PharmaCord Lynk; identify trends and opportunities for improvement.
Qualifications Completion of Bachelor’s degree (or higher) required; healthcare administration, social science, or related fields preferred. In lieu of degree: 5-10 years of experience in insurance reimbursement, patient access, direct patient care, and/or patient education; other certifications considered (e.g., PACS, CHES, CCM).
Minimum two years in healthcare access delivery or management, strongly preferred.
Strong understanding of medical terminology, coding (ICD-10, CPT, HCPCS), and insurance processes.
Excellent communication and organizational skills; ability to work in a fast-paced environment and prioritize tasks; critical thinking and issue resolution abilities.
Knowledge of HIPAA and Medicare/Medicaid guidelines; bilingual skills are a plus.
Work location notes: PharmaCord is located in Jeffersonville, IN; toll reimbursement is provided according to policy. Remote work eligibility is subject to program criteria and business needs.
Physical Demands & Work Environment Office-based role; ability to sit for extended periods; ability to type at least 35 WPM with 97% accuracy.
Occasional travel may be required; standard office environment with normal equipment usage.
Standard shifts between 8:00 am and 11:00 pm, Monday through Friday; shifts may vary based on business needs.
Benefits and Compensation Company-paid Short-Term Disability (STD); competitive 401(k) with up to 4% match; medical, dental, and vision benefits; wellness discounts up to $260/year; annual HSA employer contribution; life insurance options; voluntary coverages; parental leave; PTO, flex days, and holidays; tuition reimbursement up to $5,000/year; employee referral program.
Toll reimbursement program (valued at $678.60 per year).
Competitive starting pay; remote-work eligibility per program rules; multiple shift options between 8 AM and 11 PM, Monday–Friday.
Additional Information Offer of employment contingent on background check; job description may change with business needs.
PharmaCord is an equal opportunity employer and does not sponsor at this time.