Care Manager

Title: Care Manager - Patient Call Center (Remote)

Location(s):
Oregon City, OR, United States
Denver, CO, United States
Bismarck, ND, United States
Casper, WY, United States
Chamberlain, SD, United States
Flagstaff, AZ, United States
California, United States
Moab, UT, United States
Reno, NV, United States
Santa Rosa, CA, United States

Details:
Home-Based | Full-Time

Job Description:
This is posted in anticipation of a future role.

Position Summary:
Care Managers are responsible for contacting insurance companies to obtain correct eligibility information, performing benefit investigations, assisting with copay programs, and checking prior authorization and/or appeal status.

The information contained herein is intended to be an accurate reflection of the duties and responsibilities of individuals assigned to this position. It is not intended to be an exhaustive list of all skills and abilities required. IQVIA reserves the right to revise the job or require that other or different tasks be performed as assigned.

This role will be a contract position with IQVIA, managed by an external agency, with the opportunity to convert to a full-time IQVIA employee.

Care Manager Overview:
As a global provider of commercial solutions, IQVIA understands what it takes to deliver both nationally and internationally. Our teams help biopharma organizations deliver their medicines to the patients who need them. We help customers gain insight into and access their markets, and ultimately demonstrate their product’s value to payers, physicians, and patients.

A significant part of our business includes acting as a biopharma sales force to physicians or providing nurses to educate patients or prescribers. With the right experience, you can help deliver medical breakthroughs in the real world.

Position Summary (Role-Specific):
Responsibilities will vary by program and lifecycle. Care Managers may be responsible for contacting insurance companies to obtain eligibility information, performing benefit investigations, assisting with copay programs, and checking prior authorization and/or appeal status.

Care Managers may also contact patients and/or providers directly to evaluate eligibility for assistance programs and provide adherence support. This is a remote position.

Job Responsibilities:

• Perform outbound calls to obtain appropriate information and document accurately
• Answer inbound calls and assist customers with pharmacy-related services
• Maintain professionalism in all communications while providing efficient, courteous, and friendly service
• Contact insurance companies for benefit investigation and coverage eligibility
• Provide prior authorization and appeals support
• Assist patients with enrollment in manufacturer and non-profit organization copay assistance programs
• Update job knowledge by participating in educational opportunities and training activities
• Work efficiently both independently and within a team to accomplish required tasks
• Maintain and improve quality results by adhering to standards and meeting program KPIs
• Report adverse drug events (ADEs) according to program policies and guidelines
• Adhere to all HIPAA guidelines
• Assist with onboarding new employees as needed

Schedule:
Must be available for an 8-hour shift between 8:00 AM – 8:00 PM EST

Required Qualifications:

• High School Diploma or equivalent
• Minimum one year of experience in medical billing, reimbursement, insurance verification, or similar medical office experience
• Previous data entry experience (minimum three months) with typing speed of 30 WPM or higher
• High attention to detail
• Strong computer skills, including navigating multiple tabs, monitors, and applications
• Proficiency in Microsoft Office Suite (Teams, Word, Excel, Outlook) and soft phone systems (e.g., WebEx, Mitel, ShoreTel)
• Excellent written and verbal communication skills
• Ability to work effectively in a virtual team environment and remain responsive during working hours
• Strong follow-through and accountability
• Private, distraction-free workspace compliant with HIPAA requirements
• Internet with plug-in (wired) connection; Wi-Fi is not permitted
• Must reside in the country where the job is posted

Preferred Qualifications:

• Some college education
• Bilingual (Spanish/English)
• Experience in Patient Support Services (Hub)
• Customer service experience in the healthcare field

About IQVIA:
IQVIA is a leading global provider of clinical research services, commercial insights, and healthcare intelligence to the life sciences and healthcare industries. The company creates intelligent connections to accelerate the development and commercialization of innovative medical treatments, improving patient outcomes and population health worldwide.

Learn more: https://jobs.iqvia.com

IQVIA is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by applicable law. https://jobs.iqvia.com/eoe

IQVIA is committed to integrity in our hiring process and maintains a zero tolerance policy for candidate fraud. All information and credentials submitted in your application must be truthful and complete. Any false statements, misrepresentations, or material omissions during the recruitment process will result in immediate disqualification of your application, or termination of employment if discovered later, in accordance with applicable law. We appreciate your honesty and professionalism.

The potential base pay range for this role is $22.00 - $23.00 per hour. The actual base pay offered may vary based on a number of factors including job-related qualifications such as knowledge, skills, education, and experience; location; and/or schedule (full or part-time). Dependent on the position offered, incentive plans, bonuses, and/or other forms of compensation may be offered, in addition to a range of health and welfare and/or other benefits.