McKesson Case Manager II in Louisville, Kentucky
McKesson is in the business of better health and we touch the lives of patients in virtually every aspect of healthcare. At McKesson Specialty Health, our products and services span the full continuum of specialty patient care. From the initial phases of a product life cycle and the distribution of specialty drugs, to fully integrated healthcare technology systems, practice management support, and ultimately to patient care in the communities where they live, we empower the community patient care delivery system by helping community practices advance the science, technology and quality of care.
We have a vision —that the long-term vibrancy of community care will be achieved through the leadership of physicians committed to clinical excellence and innovation, enabled by close collaboration with our organization and our deep clinical, operational and technological expertise.Every single McKesson employee contributes to our mission—by joining McKesson Specialty Health you act as a catalyst in a chain of events that helps millions of people all over the globe. You’ll collaborate on the products and solutions that help us carry out our mission to improve lives and advance healthcare. Working here is your opportunity to shape an industry that’s vital to us all.
Shift : 11:30-8:00
Join our team of leaders to begin a rewarding career.
Job Summary: To monitor processing of cases for patients with specialty pharmacy vendors and home health agencies to overcome delay in turnaround times and other obstacles. The Case Manager I will be in regular contact with vendors. Occasionally, the Case Manager will contact physician offices, payers, specialty pharmacies, and pharmaceutical company representatives.
Monitors drug shipments and patient training between patients, physician offices and specialty pharmacies
Work with vendor contacts (specialty pharmacies and/or Home Health agencies) to expedite approval and delivery of medication and injection administration and/or injection teach
Understand reason for denial and take appropriate actions to resolve case
Re-triage cases to appropriate specialty pharmacy when/if appropriate in a timely manner
Respond to vendor statuses (written, electronic or verbal) making appropriate entries into NG system
Set follow up alarms as appropriate to resolve patient prescription request
Communicate with Case Managers II (CMII), Case Managers III (CMIII), and to work with medical practices, sales representatives regarding the status of cases
Provide consultative services where issues arise on how obstacles can be overcome in order to get patient on paid therapy
Works with CMII and CMIII to obtain missing information
Develops and works daily report and maintains e-mail of pending cases in a timely fashion
Coordinates and schedules conference calls with vendor contact and/or home health company to review status of cases
Maintains all patient confidentiality
Other duties and responsibilities as assigned by supervisor.
Preferred Minimum Qualifications:
Prefer three years of experience in reimbursement case management, preferable in the insurance and/or pharmaceutical/biotechnology industry.
Proficient in all aspects of reimbursement (i.e. benefit investigation, prior authorization, precertification).
Skilled in verbal and written communication
Knowledge of Medical Terminology
Extensive knowledge of drug reimbursement issues and claim adjudication process Knowledge of navigation through the claim denial process.
Knowledge of HCPCS, CPT and ICD-9 coding
Ability to express ideas clearly both written and oral communications
Ability to enter data correctly
Strong attention to detail and ability to handle multiple tasks well
Strong computer skills required; preferably Microsoft Word or Excel software applications
Data entry skills required
Ability to resolve problems independently
Ability to calculate figures and amounts such as discounts and percentages
Ability to carry out instructions furnished in written, oral or diagram form
Adaptable to changing priorities as needed
Have exceptional attention to detail and excellent analytical, investigation, and problem solving skills
Ability to manage multiple priorities concurrently
Responsible for meeting quality and turn-around-time objectives
Strong customer service skills; including ability to convey compassion for patients
A designation as a Certified Case Manager or licensed practical nurse or social worker is also preferred Physical Demands: May sit, stand, stoop, bend and walk intermittently during the day. May sit or stand seven (7) to ten (10) hours per day. May be necessary to work extended hours as needed. Finger dexterity to operate office equipment required. May need to lift up to twenty-five (25) pounds on occasion. Visual acuity to see and read fine prints. Specific vision abilities required by this role include close vision, color vision and the ability to adjust focus. Must be able to hear normal voice sounds. The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this role. Work Environment: Work in a climate-controlled, smoke-free internal environment.
Benefits & Company Statement
McKesson believes superior performance – individual and team – that helps us drive innovations and solutions to promote better health should be recognized and rewarded. We provide a competitive compensation program to attract, retain and motivate a high-performance workforce, and it’s flexible enough to meet the different needs of our diverse employee population.
We are in the business of better health and we touch the lives of patients in virtually every aspect of healthcare. We partner with payers, hospitals, physician offices, pharmacies, pharmaceutical companies and others across the spectrum of care to build healthier organizations that deliver better care to patients in every setting.
But we can’t do it without you. Every single McKesson employee contributes to our mission—whatever your title, whatever your role, you act as a catalyst in a chain of events that helps millions of people all over the globe. Talented, compassionate people are the future of our company—and of healthcare. At McKesson, you’ll collaborate on the products and solutions that help us carry out our mission to improve lives and advance healthcare. Working here is your opportunity to shape an industry that’s vital to us all.
McKesson is an equal opportunity and affirmative action employer – minorities/females/veterans/persons with disabilities.
Qualified applicants will not be disqualified from consideration for employment based upon criminal history.
No agencies please.
Job: Customer Service
Organization: McKesson Specialty Health
Title: Case Manager II
Requisition ID: 18004729