Care Manager – (Home-Based)

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.

Position Summary:

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: Ability to work 40 hours per week.

Shifts based on availability : 8:30 am EST – 5:00 pm EST or 9:00 am – 6:00 pm EST or 10:00 am – 7:00 pm EST or 11:00 am EST – 8:00pm EST under moderate supervision

Salary: $22/hr

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.

Primary Responsibilities:

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

Required Qualifications:

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.

Preferred Qualifications:

Previous experience in Patient Support Services (Hub)

Previous Customer Service experience in the healthcare field

Bilingual

Professional Competencies:

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 clinical research services, commercial insights and healthcare intelligence to the life sciences and healthcare industries. We create intelligent connections to accelerate the development and commercialization of innovative medical treatments to help improve patient outcomes and population health worldwide. 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

The potential base pay range for this role is $22.00 per hour. 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.

IQVIA is a world leader in using data, technology, advanced analytics, and expertise to help customers drive healthcare – and human health – forward. Together with the companies we serve, we are enabling a more modern, more effective and more efficient healthcare system, and creating breakthrough solutions that transform business and patient outcomes.

To get there, it takes diverse skills and a curiosity to explore new possibilities. No matter your role, everyone at IQVIA, including our colleagues at Q² Solutions, contributes to our shared goal of improving human health. Thank you for your interest in growing your career with us.

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