Patient Navigator Jobs

What Individualized Care contributes to Cardinal Health
Clinical Operations is responsible for providing clinical specialties support and expertise in the areas of advice and consulting, research and patient care to internal business units and external customers.
Individualized Care provides care that is planned to meet the particular needs of an individual patient.
Qualifications

• Clear knowledge of Medicare (A, B, C, D)
• 2-4 years of Case Management experience is required
• LVN is preferred
• 1-2 years of Pharmacy and/or Medical Claims billing and Coding work experience is preferred
• Bilingual (Spanish) is a plus
• 0-2 years of experience
• Able to thrive in a competitive and dynamic environment• Intermediate to advanced computer skills and proficiency in Microsoft Office including but not limited to Word, Outlook, and preferred Excel capabilities
• BA, BS or equivalent experience in related field preferred
• Demonstrate effective, empathetic and professional communication
• Previous medical experience is preferred
• Ability to work with high volume production teams with an emphasis on quality
• Must communicate clearly and effectively in both a written and verbal format
• Previous social work experience is preferred
• Must be able to manage multiple concurrent assignments
• 1-2 years of experience with Prior Authorization and Appeal submissions

Key Characteristics

• Strong customer support skills and professional experience working with medical providers
• Problem Solving
• Adaptable and Flexible
• Great work attitude
• Punctual and Efficient
• Self-Motivated and Dependable
• Team Spirited

Responsibilities

• Deliver virtual or telephonic educational support to identified patients, caregivers, Healthcare Professionals (HCPs) and their staff to meet all relevant standards as set by the client company
• Responsible for addressing Medical Information inquiries from consumers, healthcare providers and other entities, including but not limited to, requests for product information, inquiries about side effects, guidelines for appropriate use of the product, etc.
• Converse with callers in an empathetic manner and build rapport
• Answer inbound inquiries of patients, care partners and HCPs
• Work closely with patients, patient caregivers, healthcare providers. Sonexus Health reimbursement team, the manufacturer’s employees, third party vendors to clearly identify issues and provide resolution.
• Act as primary point of contact for patients and HCPs
• Establish an ongoing relationship with each assigned patient, starting with Welcome, onboarding, treatment initiation, continuation, and ongoing interactions
• Submit all adverse event reports to manufacturer/third party vendor within stipulated timeframe; additionally follow up if requested to do so.
• Provide identification, intake, documentation, and submission of all reported Product Complaints, per the manufacturer guidelines.
• Be a champion for each patient and consented care partner(s)
• Investigate and resolve patient/healthcare provider inquiries and concerns in a timely manner
• Possess effective organizational skills, including working on multiple cases simultaneously.
• Perform other activities related to the internal initiatives and/or the manufacturer’s programs as assigned.
• Exhibit effective communication and tele-management skills.
• Provide support and guidance to help ensure patients have access to the patient support program resources by compliantly navigating reimbursement, and mitigating any patient out-of-pocket barriers, as applicable
• Concurrently handle multiple outstanding issues and ensure all items are resolved in a timely manner to the satisfaction of all parties
• Must adhere to strict guidelines regarding the protection of proprietary educational materials and product information that may be printed or available via email, websites, or other electronic means, provided by the manufacturer.
• Experience in supporting time sensitive requests and prioritization of assignments and working with a sense of urgency.
• Responsible for maintaining HIPAA guidelines.
• Proactive follow-up with various contacts to ensure patient access to therapy.
• Patient Navigators work closely with the Case Managers to coordinate care and educational opportunities for patients, patient caregivers, and healthcare providers regarding the patient journey.
• Responsible for the identification, intake, documentation, and submission of all Adverse Event Reports occurring in patients which are taking or have previously taken the manufacturer’s product.
• Understand a patient’s support needs and interaction preferences to deliver a seamless, tailored patient experience that helps each patient complete their pathway to treatment as prescribed by their HCP
• Support healthcare providers with Prior Authorization and Appeals submission to Insurance carrier.
• Responsible for meeting the newly identified patient, patient caregivers, healthcare providers over the phone to provide education on the drug, disease process, diagnostic testing, support services provided by the manufacturer and review benefit information.
• Act as patient and healthcare providers single point of contact for all inquiries

What is expected of you and others at this level

• Works under direct supervision and receives detailed instructions
• Develops competence by performing structured work assignments
• Follows established procedures to resolve readily identifiable technical problems
• Works on projects of limited scope and complexity
• Applies basic concepts, principles and technical capabilities to perform routine tasks

TRAINING AND WORK SCHEDULES: Your new hire training will take place 8:00am-5:00pm CST, mandatory attendance is required.

This position is full-time (40 hours/week). Employees are required to have flexibility to work any of our shift schedules during our normal business hours of Monday-Saturday, 7:00am- 7:00pm CST.

REMOTE DETAILS: You will work remotely, full-time. It will require a dedicated, quiet, private, distraction free environment with access to high-speed internet. We will provide you with the computer, technology and equipment needed to successfully perform your job. You will be responsible for providing high-speed internet. Internet requirements include the following:

Maintain a secure, high-speed, broadband internet connection (DSL, Cable, or Fiber) at the remote location. Dial-up, satellite, WIFI, Cellular connections are NOT acceptable.

• Surge protector with Network Line Protection for CAH issued equipment
• Upload speed of 5Mbps (megabyte per second)
• Ping Rate Maximum of 30ms (milliseconds)
• Hardwired to the router
• Download speed of 15Mbps (megabyte per second)

Cardinal Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, ancestry, age, physical or mental disability, sex, sexual orientation, gender identity/expression, pregnancy, veteran status, marital status, creed, status with regard to public assistance, genetic status or any other status protected by federal, state or local law.