Access And Patient Support: Case Manager

Patient Access And Advocacy Specialist

Cardinal Health Sonexus Access and Patient Support helps specialty pharmaceutical manufacturers remove barriers to care so that patients can access, afford and remain on the therapy they need for a better quality of life. Our diverse expertise in pharma, payer and hub services allows us to deliver best-in-class solutions-driving brand and patient markers of success. We're continuously integrating advanced and emerging technologies to streamline patient onboarding, qualification and adherence. Our non-commercial specialty pharmacy is centralized at our custom-designed facility outside of Dallas, Texas, empowering manufacturers to rethink the reach and impact of their products.

Responsibilities

Patient Access & Advocacy

• Support patient access to therapy through reimbursement support services and patient support programs, in accordance with business rules and HIPAA regulations.
• Guide patients and healthcare providers through all steps of the patient journey, including referral intake, benefit investigation (pharmacy and medical), prior authorization, and therapy delivery.
• Actively advocate for patients by navigating complex healthcare systems, addressing concerns, and securing necessary approvals for treatments and medications.
• Assess patient financial ability and provide guidance to appropriate financial assistance programs.
• Implement strategies to promote medication adherence, including patient education, regular check-ins, and addressing barriers to compliance.
• Evaluate patient eligibility for assistance programs and assist with enrollment.

Care Coordination & Insurance Navigation

• Manage the entire care process from benefit investigation/verification to medication delivery, ensuring an exceptional patient experience.
• Conduct benefit verifications and collaborate with physicians, pharmacies, and insurance companies for seamless coordination and timely access to services.
• Help patients understand insurance coverage, out-of-pocket costs, and appeals processes.
• Assist in obtaining insurance, prior authorization, and appeal requirements and outcomes.
• Remain knowledgeable about changes in the reimbursement environment (Medicare, Medicaid, Managed Care, Commercial plans).

Program Expertise & Continuous Improvement

• Remain updated on available patient resources and oversee systems and procedures for accuracy and efficiency.
• Demonstrate deep understanding of the patient support program and contribute to its continuous improvement.
• Track key patient metrics, analyze data for trends and improvement opportunities, and generate reports for stakeholders.
• Anticipate potential problems, refer to policies and past practices, and develop effective solutions.
• Provide guidance and training to junior case managers on best practices.

Communication & Collaboration

• Provide world-class service, striving for one-call resolution for inbound calls from patients, healthcare provider offices, specialty pharmacies, and customers.
• Mediate effective resolution for complex payer/pharmacy issues and de-escalate situations.
• Collaborate with internal and external teams, focusing on problem-solving and teamwork.
• Build and maintain professional relationships with all stakeholders, including case management, patient support services, medical, sales, market access, insurance companies, specialty pharmacies, and office coordinators.
• Display high emotional intelligence and professional communication to foster strong working relationships.

Documentation & Compliance

• Maintain accurate and detailed notations for every interaction using the appropriate database/CRM.
• Document and share reimbursement and other knowledge with team members.
• Ensure compliance with company and manufacturer policies.
• Track payer/plan issues and report changes, updates, or trends to management.
• Handle escalations and ensure proper communication of resolutions within required timeframes.

Other Duties

• Provide caseload coverage outside of assigned duties/territory as needed.
• Make outbound calls for patient follow-ups or confirmations.
• Proactively follow up with partners to facilitate coverage and timely product delivery.
• Cultivate innovation by monitoring systems, processes, and care gaps, offering new ideas and solutions.

Qualifications

High School Diploma, GED, or technical certification required; college degree preferred.

3-8 years of industry experience with patient-facing or high-touch customer interaction experience, preferred.

In-depth understanding of health insurance benefits, relevant state and federal laws, and insurance regulations.

Strong understanding of pharmaceutical therapies, disease states, and medication adherence challenges.

Excellent written and oral communication, mediation, and problem-solving skills.

Experience managing complex patient cases, preferably with specialty medications.

Robust computer literacy, including data entry and MS Office-based software programs.

Ability to work independently, prioritize effectively, and thrive in a fast-paced, dynamic environment.

Strong people skills: flexibility, persistence, creativity, empathy, and trust.

Bilingual (Spanish) skills preferred.

Work Schedule & Remote Details

Full-time (40 hours/week).

Flexibility to work any shift during normal business hours: Monday-Friday, 7:00am-7:00pm CT/CST.

Mandatory new hire training: 8:00am-5:00pm CT/CST.

Remote work requires a dedicated, quiet, private, distraction-free environment with high-speed internet (DSL, Cable, or Fiber; dial-up, satellite, WiFi, cellular not acceptable).

Download speed: 15Mbps; Upload speed: 5Mbps; Ping rate: max 30ms; hardwired to router; surge protector with network line protection for company-issued equipment.

These responsibilities provide an overview of the position and may be adjusted according to business requirements. The organization reserves the right to modify duties, reporting structure, or assign additional tasks as needed. This job description is subject to revision at any time.

Anticipated hourly range: ?$21.50 per hour - $30.70 per hour

Bonus eligible: ?No

Benefits: ?Cardinal Health offers a wide variety of benefits and programs to support health and well-being.

Medical, dental and vision coverage

Paid time off plan

Health savings account (HSA)

401k savings plan

Access to wages before pay day with myFlexPay

Flexible spending accounts (FSAs)

Short- and long-term disability coverage

Work-Life resources

Paid parental leave

Healthy lifestyle programs

Application window anticipated to close: ?12/26/2025 *if interested in opportunity, please submit application as soon as possible. The hourly range listed is an estimate. Pay at Cardinal Health is determined by multiple factors including, but not limited to, a candidate's geographical location, relevant education, experience and skills and an evaluation of internal pay equity.

Candidates who are back-to-work, people with disabilities, without a college degree, and Veterans are encouraged to apply.

Cardinal Health supports an inclusive workplace that values diversity of thought, experience and background. We celebrate the power of our differences to create better solutions for our customers by ensuring employees can be their authentic selves each day. 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.