Pharmacy Case Manager - Patient Access
Job Description
Pharmacy Case Manager - Patient Access
Pay: $20.00/hour
Employment Type: Full-Time (40 hours/week)
Location: Remote (U.S.)
Pharmacy Case Manager - Patient Access Schedule & Training
- Training Schedule: 8:00 AM – 5:00 PM CST (mandatory attendance)
- Regular Schedule: Monday–Friday, between 7:00 AM – 8:00 PM CST
- Must have flexibility to work any assigned shift within business hours
Remote Work Requirements
This is a fully remote position. You must have a dedicated, quiet, distraction-free workspace.
Company-provided equipment: Computer and necessary technology will be supplied.
Employee-provided requirement: High-speed internet meeting the following standards:
- Secure broadband connection (DSL, Cable, or Fiber only)
- Minimum 15 Mbps download
- Minimum 5 Mbps upload
- Maximum 30 ms ping
- Must be hardwired to router (no WiFi-only connections)
- Surge protector with network line protection required for company equipment
- Not acceptable: Dial-up, satellite, WiFi-only, or cellular connections
About the Role
This role supports patients accessing specialty therapies by helping remove barriers to care and ensuring timely coordination between patients, healthcare providers, pharmacies, and insurance companies.
As a Pharmacy Case Manager - Patient Access, you will manage end-to-end patient support activities, including benefit verification, insurance coordination, and medication access support. You will serve as a key point of contact to ensure patients receive timely and appropriate care.
Pharmacy Case Manager - Patient Access Key Responsibilities
- Handle inbound and outbound calls from patients, providers, specialty pharmacies, and customers
- Work toward one-call resolution and provide an exceptional patient experience
- Manage the full care process from benefit investigation through medication delivery
- Perform insurance benefit verifications and eligibility checks
- Coordinate with healthcare providers, pharmacies, and insurance companies
- Assist with prior authorizations, appeals, and required documentation
- Educate patients on insurance coverage, out-of-pocket costs, and appeals processes
- Resolve patient and provider inquiries regarding case status
- Navigate payer systems including Medicare, Medicaid, Managed Care, and Commercial plans
- Process patient enrollments via fax, phone, and electronic systems
- Review documentation for accuracy and completeness, ensuring proper data entry
Pharmacy Case Manager - Patient Access Qualifications
- 2–4 years of industry experience preferred in patient-facing, healthcare, or high-touch customer service roles
- Experience with hub services or patient support programs preferred
- High school diploma or equivalent preferred
- Knowledge of Medicare (A, B, C, D), Medicaid, and commercial insurance plans preferred
- Strong interpersonal skills: empathy, flexibility, persistence, and problem-solving
- Proficient computer skills including data entry and Microsoft Office
- Understanding of pharmaceutical therapies and disease states preferred
- Excellent written and verbal communication skills
What We Expect From You
- Apply job knowledge and company procedures to complete assigned tasks
- Use technical or specialized knowledge to resolve complex issues
- Work independently within established guidelines
- Adapt processes when needed to resolve unique situations
- May support or guide less experienced team members
- Demonstrate strong problem-solving and decision-making skills