FREE ACCESS
5,000–10,000 jobs/day
See all jobs on Scoutfield
Search thousands of fresh jobs every day.
Discover
- Fresh listings
- Fast filters
- No subscription required
Create a free account and start exploring right away.
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in case management oversight, ensuring timely completion of case elements and effective communication with patients and healthcare providers. Proficient in pharmacy benefit management and skilled in critical thinking and multi-tasking.
Highest-signal resume keywords
Case Management OversightPharmacy Benefit ManagementBenefits InvestigationExcellent Communication SkillsCritical Thinking
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Case CoordinationQuality ChecksAdverse Drug Event ReportingMedical TerminologyClaims Processing
Soft Skills
Multi-taskingTroubleshootingProviding Clear Instructions
Tools & Technologies
MicroSoft OfficeSalesforce
Certifications & Qualifications
Certification Preferred
Industry Keywords
Prior AuthorizationPatient Assistance ProgramsHealthcare ProvidersField Reimbursement Representatives
About the role
Key responsibilities & impact- Provide day-to-day case management oversight and coordination of assigned caseload
- Ensure case elements and tasks are completed timely and cases move through the process as required
- Act as single point of contact for prior authorization and appeal processing communications
- Communicate with patients, healthcare providers, field reimbursement representatives and other external stakeholders
- Communicate patient benefits and responsibility timely and accurately
- Assess and refer patients for special programs/services when appropriate
- Perform quality checks on cases and report trends to leadership
- Troubleshoot complex cases spanning multiple disease-states
- Interface with internal and external stakeholders to ensure optimal start to therapy
- Report Adverse Drug Events according to pharmaceutical requirements
- Recognize product quality complaints and forward caller/written information to a manufacturer
- Perform other duties as assigned
Requirements
What you’ll need- Bachelor’s degree or six years of relevant working experience
- Two (2) or more years of relevant experience in pharmacy benefit management
- Experience in full benefits investigation
- PAP experience is preferred
- Certification preferred but not required
- Proficient in MicroSoft Office applications
- Knowledge of medical and claims processing terminology
- Excellent written/verbal communication to include providing clear instructions
- Strong critical thinking skillset
- Ability to multi-task
- Salesforce experience preferred
- Must comply with applicable company, state and federal safety and environmental programs and procedures
Benefits
Comp & perks- Remote opportunities
- Growth opportunities for promotion
- 401K with company match
- Tuition reimbursement
- Flexible work environment
- PTO (Paid Time Off)
- Paid Holidays
- Employee assistance programs
- Medical, Dental, and vision coverage
- HSA/FSA
- Telemedicine (Virtual doctor appointments)
- Wellness program
- Adoption assistance
- Short term disability
- Long term disability
- Life insurance
- Discount program