Dedicated Case Coordinator NY Metro

About the Role

The Inflammation and Immunology Dedicated Case Coordinator (DCC) is a non‑promotional, field‑based role that supports patients’ access to PDPA and VFM products when prescribed by a licensed healthcare provider. The DCC owns the continual management and progression of the patient journey—from HUB enrollment through post‑fill follow‑up—working directly with patients, providers, payers, HUB partners, and third‑party vendors. This dual patient‑ and HCP‑facing role carries 100% ownership of every case in the assigned geography.

Responsibilities

• Own 100% of assigned cases and drive continual management from HUB enrollment through post‑fill follow‑up; serve as the central point of contact for patients/caregivers and HCPs regarding reimbursement and access support; answer access and coverage questions; maintain a clear understanding of the patient access journey.
• Benefits Investigation & Financial Navigation: Conduct Summary of Benefits discussions; obtain missing information on the Patient Enrollment Form; walk patients through out‑of‑pocket costs, deductibles, copay options, and reimbursement programs; verify product and baseline test coverage across PBM and major medical plans; oversee prior authorization submissions and verification; conduct benefit investigation and verification calls with payers and patients; communicate coverage, cost, PA, appeal requirements, and Interim Care program deadlines.
• Appointment & Assessment Coordination: Schedule, reschedule, and confirm patient appointments in coordination with patients, providers, and vendors; secure confirmation communication (CFT); coordinate compliantly with IQVIA/MDX on patient assessment tests.
• Program & Copay Administration: Manage Interim Care (IC) program administrative requirements and deadlines; confirm voucher eligibility and triage voucher shipment; maintain copay portal access and assist commercial patients with copay cards; own copay eligibility attestation; follow up post‑fill to ensure copay card functionality.
• Prescription Triage, Fulfillment & Ongoing Follow‑Up: Triage vouchers, paid prescriptions, and Interim Care fills within Polaris; contact patients at 10 days and again at 45 days post‑prescription to resolve logistical or financial questions.
• Case & Systems Ownership: Manage and update various case types in Polaris using texting, faxing, and prescription‑triage capabilities; interpret prior authorization, appeal, and PEF documentation; share and manage cases with HUB partners; coordinate with Pfizer colleagues via tasks and secure messages; maintain real‑time case comments; use Kite Works encrypted email for correspondence; manage Docusign consents; develop organized, compliant case‑management processes.
• Compliance, Safety Reporting & Communication: Report adverse events per company requirements; operate within strict content controls and system permissions; communicate access options using brand‑approved materials; maintain discretion and confidentiality; adhere to company compliance guidelines; work cross‑functionally to improve the patient access journey; link customer insights to resources; build trust through compliant follow‑up; demonstrate excellence in responsible business communication.

Qualifications

• B.S. or B.A. degree.
• 8+ years of pharmaceutical (or related) experience in customer‑facing roles/functions.
• Minimum 6 months as a FRM, PAC, FAS, or similar role in access and reimbursement, with experience using the Polaris CRM system.
• Working proficiency in Polaris, including case management, documentation, prescription triage, and interpretation of PA, appeal, and PEF documentation.
• Demonstrated ability to communicate directly with patients, providers, and cross‑functional colleagues.
• Experience conducting benefit investigation and verification directly with payers; knowledge of prior authorization and appeals processes.
• Working knowledge of copay programs, maximizers, accumulators, vouchers, and interim care programs.
• Ability to own a high volume of concurrent cases (average ~20 days) with disciplined documentation and follow‑through.
• Ability to meet adverse event reporting obligations in a role with frequent direct patient contact.
• Strong understanding of reimbursement, government payment systems, specialty pharmacy networks, co‑pay assistance programs, and specialty medication area.
• Appropriate and compliant communication and collaboration with cross‑functional field‑based colleagues (Sales, Medical, FRM, PCA/SAS, KAD, Government Relations) to ensure optimal patient access.
• Alignment with HQ stakeholders (Brand and Customer Marketing teams, PCA/SAS teams) to support patient access.

Preferred Qualifications

• Experience in a patient‑ or customer‑facing role requiring access and reimbursement education.
• Experience working with a HUB.
• Familiarity with Kite Works or a comparable encrypted email platform, Docusign, and copay portal administration.
• Experience coordinating with third‑party vendors on patient assessment, testing, or specialty pharmacy logistics (e.g., IQVIA/MDX, Sonexus).
• Experience supporting Interim Care, free‑goods, or bridge programs.
• Experience with both pharmacy benefit (PBM) and major medical