Specialist, Health Services

Mckesson Corporation Louisville , KY 40202

Posted 2 months ago

JOB DESCRIPTION:

o To drive paid therapy outcomes for patients, providers, pharmaceutical company representatives and healthcare service companies for specialty prescription drugs with reimbursement and billing challenges.

o Coordinate care for patients using the program

o Conduct Benefit Investigations as necessary

o Answer inbound calls to the case manager queue

o Communicate with key medical practice accounts, sales representatives regarding the status of cases. Provide consultative services where issues arise on how obstacles can be overcome in order to get patient on paid therapy.

o Communicate with internal partners to ensure case coordination. Level of communication must be superior to service key accounts

o Designates cases where missing information from the prescriber is an obstacle in moving the case forward to paid therapy and provides this information to the prescribers and Sales Representatives.

o Updates prescribers and Sales Representatives on the case status; The prescriber and patient receive an update on the case when any activity occurs that moves the case forward.

o Coordinates and schedules weekly conference calls with Sales Representatives to review status of cases

o Acts as a partner with pharmaceutical sales representatives in supporting prescriber offices and patients in moving cases to paid therapy as needed within program policies and procedures

o Report Adverse Events (AE)

o Report on Product Quality Complaints

o Maintains all patient confidentiality

o Other duties and responsibilities as assigned by supervisor based on the specific client contract.

  • Minimum (Required)

    Qualifications:
    (must be met in order to perform the job at the required level)
  • o High School Diploma or Equivalent

o Three to Five years' experience in reimbursement case management, preferable in the insurance and/or pharmaceutical/biotechnology industry

o Working knowledge of reimbursement (i.e. benefit investigation, prior authorization, pre-certification, letters of medical necessity

Preferred Qualifications:
(if above and beyond the minimum required)

o Knowledge of Medical Terminology preferred

o Working knowledge of drug reimbursement issues

o Knowledge of HCPCS, CPT and ICD-9 coding

o Ability to negotiate favorable outcomes with payer and prescribers in obtaining needed information and decisions

o Ability to express ideas clearly in both written and oral communications

o Strong attention to detail and ability to multi-task

o Strong computer skills required; preferably Microsoft Word or Excel software applications

o Data entry skills required

o Ability to resolve problems independently

o Ability to follow instructions

o Adaptable to changing priorities as needed

o Have exceptional attention to detail and excellent analytical, investigation, and problem solving skills

o Ability to manage multiple priorities concurrently

o Responsible for case management for patient accounts

detailed weekly spreadsheets on all cases (Pending and Approved)

detailed weekly spreadsheets to patient accounts

verify that medication is ready to ship

communicate with MDO on issues

o Responsible for meeting quality and turn-around-time objectives

o Strong customer service skills; including ability to convey compassion for patients

Physical Demands: May sit (7) to ten (10) hours per day.

May be necessary to work extended hours as needed. Finger dexterity to operate office equipment required. May need to lift up to twenty-five (25) pounds on occasion.

Visual acuity to see and read fine prints. Must be able to hear normal voice sounds. The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this role.

Work Environment: Work in a climate-controlled, smoke-free internal environment.

These job responsibilities are executed as part of a customer service call center. The position will be located in a fast-paced organization with the potential for a variety of unplanned activities to occur simultaneously.

McKesson is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, creed, sex, sexual orientation, gender identity, national origin, disability, or protected Veteran status.

Qualified applicants will not be disqualified from consideration for employment based upon criminal history. McKesson is committed to being an Equal Employment Opportunity Employer and offers opportunities to all job seekers including job seekers with disabilities. If you need a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to Disability_Accommodation@McKesson.com.

Resumes or CVs submitted to this email box will not be accepted. Continue to grow your career with McKesson!

CAREER LEVEL: B4

Career Level - IC-Business Support-B4

McKesson is an Equal Opportunity/Affirmative Action employer.

All qualified applicants will receive consideration for employment without regard to race, color, religion, creed, sex, sexual orientation, gender identity, national origin, disability, or protected Veteran status.Qualified applicants will not be disqualified from consideration for employment based upon criminal history.

McKesson is committed to being an Equal Employment Opportunity Employer and offers opportunities to all job seekers including job seekers with disabilities. If you need a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to McKessonTalentAquisition@McKesson.com . Resumes or CVs submitted to this email box will not be accepted.

Current employees must apply through the internal career site.

Join us at McKesson!



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Specialist, Health Services

Mckesson Corporation