McKesson Case Manager III 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.
Join our team of leaders to begin a rewarding career.
Case Manager III
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 ofexperience in reimbursement case management, preferable in the insurance and/orpharmaceutical/biotechnology industry.
Proficient in allaspects of reimbursement (i.e. benefit investigation, prior authorization, pre-certification).
Skilled in verbal andwritten communication
Knowledge of MedicalTerminology
Extensive knowledge ofdrug reimbursement issues and claim adjudication process
Knowledge of navigationthrough the claim denial process.
Knowledge of HCPCS, CPTand ICD-9 coding
Ability to express ideasclearly both written and oral communications
Ability to enter datacorrectly
Strong attention todetail and ability to handle multiple tasks well
Strong computer skillsrequired; preferably Microsoft Word or Excel software applications
Data entry skillsrequired
Ability to resolveproblems independently
Ability to calculatefigures and amounts such as discounts and percentages
Ability to carry outinstructions furnished in written, oral or diagram form
Adaptable to changingpriorities as needed
Have exceptionalattention to detail and excellent analytical, investigation, and problem solving skills
Ability to managemultiple priorities concurrently
Responsible for meetingquality and turn-around-time objectives
Strong customer serviceskills; including ability to convey compassion for patients
A designation as aCertified Case Manager or licensed practical nurse or social worker is alsopreferred
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 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 III
Requisition ID: 18008945