Bilingual Executive Case Manager

Job Title

Bilingual Executive Case Manager at Pharma Cord

When you join the team as a Bilingual Executive Case Manager, you'll have the opportunity to make a difference in the lives of our patients each day as they look to you as part of their dedicated support team for helping them navigate the tricky process of getting access to their complex medication. You will compassionately deliver an exceptional experience to many patients per day, always remembering that every prescription or document belongs to a real person who is looking for thorough and efficient management of their records.

You will adjust your approach to their needs by communicating clearly, focusing on the accuracy of the details of their medical records, your mastery of the program requirements, and ensuring their prescriptions or cases are handled in a timely manner. An Executive Case Manager has the ability to translate knowledge into patient‑friendly language and education.

A typical day in this role will include ownership of your patient journey from initiation to closure by using your critical thinking skills and your knowledge of the program and industry rules and standards. This includes completing benefit investigations, tracking prior authorizations/denial appeals, and assisting patients or other callers/stakeholders through resolution (via email, inbound/outbound calls and using our patented technology, Lynk).

This role requires a strong understanding of pharmacy and medical billing and coding, excellent communication skills, and the ability to navigate complex reimbursement processes.

The Executive Case Manager provides expertise on insurance coverage and common access and reimbursement challenges affecting patients, healthcare providers and clients. The Executive Case Manager responsibilities include education on the access and reimbursement support tools available from Pharma Cord and participating program, advising HCPs and/or patients and caregivers on the benefits and program eligibility for a specific patient, and educating HCP offices on Payor processes and procedures.

Important Notice – Due to an increase in hiring scams, please be aware that if you are selected to move forward in our hiring process, a member of our Talent Acquisition team will contact you directly using an official and/or email address regarding next steps in our interview process. Pharma Cord will never use Microsoft Teams to reach out to candidates for interview scheduling.

However, video interviews are typically conducted via Microsoft Teams. Official meeting links will always be sent from an  or  email address, or through our scheduling platform, Calendly. We will never request your bank account information at any stage of the hiring process. We will never send a check (electronic or physical) to purchase home office equipment. If you receive any suspicious communication regarding employment with Pharma Cord, please report it to our Talent Acquisition team immediately at .

• Ownership of the patient journey from initiation to closure by using your critical thinking skills and knowledge of the program and industry rules and standards.
• Complete benefit investigations.
• Track prior authorizations and denial appeals.
• Assist patients and other callers/stakeholders through resolution via email, inbound/outbound calls, and using Lynk.
• Provide expertise on insurance coverage and common access and reimbursement challenges.
• Educate HCP offices on payor processes and procedures.
• Relationship Management
• Build trusted relationships with patients, prescribers, and appropriate client stakeholders regarding reimbursement inquiries and challenges.
• Adhere to laws, regulations, and program procedures.
• Perform post Benefits Investigation calls to patients and/or physicians explaining coverage options and next steps in the access journey.
• Manage all client inquiries, including case-specific statuses.
• Manage HCP inquiries as applicable, pursuant to business rules.
• Inbound Call Management
• Manage inbound calls as directed by the program-approved FAQs.
• Triage patients to internal or external resources as appropriate.
• Personalized Case Management
• Pro…