You'll compassionately deliver an exceptional experience to many patients per day always ... The Executive Case Manager provides expertise on insurance coverage and common access and ...
You'll compassionately deliver an exceptional experience to many patients per day always ... The Executive Case Manager provides expertise on insurance coverage and common access and ...
Executive Case Manager (Remote)
Raleigh, NC · On-site +1
You'll compassionately deliver an exceptional experience to many patients per day always ... The Executive Case Manager provides expertise on insurance coverage and common access and ...
Executive Case Manager (Remote)
Raleigh, NC · On-site +1
You'll compassionately deliver an exceptional experience to many patients per day always ... The Executive Case Manager provides expertise on insurance coverage and common access and ...
TravelAssist Case Manager
Durham, NC · On-site +1
$19 - $24.50/hr
Commensurate with experience JOB SUMMARY The TravelAssist Case Manager helps DAN members access ... remote work arrangement. Details will be discussed during the interview process
TravelAssist Case Manager
Durham, NC · On-site +1
$19 - $24.50/hr
Commensurate with experience JOB SUMMARY The TravelAssist Case Manager helps DAN members access ... remote work arrangement. Details will be discussed during the interview process
Case Manager
Raleigh, NC · Remote
$50K - $80K/yr
We are searching for the best talent fora Case Manager. Summary Performs day-to-day tasks as a ... Remote Required Skills: Preferred Skills: Accountability, Communication, Customer Analytics ...
Case Manager
Raleigh, NC · Remote
$50K - $80K/yr
We are searching for the best talent fora Case Manager. Summary Performs day-to-day tasks as a ... Remote Required Skills: Preferred Skills: Accountability, Communication, Customer Analytics ...
Remote * Case Volume: 77 RVUs * Case Types: Diagnostic * Must be board-certified Please apply for ... Experience simplified assignment management and timesheet submittals via the Medicus Portal. Unlock ...
Remote * Case Volume: 77 RVUs * Case Types: Diagnostic * Must be board-certified Please apply for ... Experience simplified assignment management and timesheet submittals via the Medicus Portal. Unlock ...
RN Field Case Manager
Raleigh, NC · On-site +1
$75K - $96K/yr
... experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can ... remote work environment that allows face to face interaction with injured workers and medical ...
RN Field Case Manager
Raleigh, NC · On-site +1
$75K - $96K/yr
... experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can ... remote work environment that allows face to face interaction with injured workers and medical ...
RN Field Case Manager
Raleigh, NC · On-site +1
$75K - $96K/yr
... experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can ... remote work environment that allows face to face interaction with injured workers and medical ...
RN Field Case Manager
Raleigh, NC · On-site +1
$75K - $96K/yr
... experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can ... remote work environment that allows face to face interaction with injured workers and medical ...
Case Manager Nurse Advocate- Raleigh area
Raleigh, NC · On-site +1
We are seeking an experienced Case Manager to join our growing team and serve as a Nurse Advocate ... This opportunity allows for remote work so can be flexible on location. Minimal travel within the ...
Case Manager Nurse Advocate- Raleigh area
Raleigh, NC · On-site +1
We are seeking an experienced Case Manager to join our growing team and serve as a Nurse Advocate ... This opportunity allows for remote work so can be flexible on location. Minimal travel within the ...
Remote Sales Representative (No Experience Required)
Raleigh, NC · Remote
$85K - $150K/yr
Manage Client Pipelines: Track all sales activities, touchpoints, and progress using our CRM ... Remote Readiness: Comfort and familiarity with working in a fully virtual environment. * Growth ...
New
Quick apply
Remote Sales Representative (No Experience Required)
Raleigh, NC · Remote
$85K - $150K/yr
Manage Client Pipelines: Track all sales activities, touchpoints, and progress using our CRM ... Remote Readiness: Comfort and familiarity with working in a fully virtual environment. * Growth ...
New
Remote Registered Nurse (RN) Case Manager
Raleigh, NC · On-site +1
$50K/yr
Valeris works on behalf of life sciences companies to improve the patient experience so that ... Case management or Clinical Trial Nurse experience, a plus. * Bachelor's degree preferred. * Remote ...
Remote Registered Nurse (RN) Case Manager
Raleigh, NC · On-site +1
$50K/yr
Valeris works on behalf of life sciences companies to improve the patient experience so that ... Case management or Clinical Trial Nurse experience, a plus. * Bachelor's degree preferred. * Remote ...
Remote Registered Nurse (RN) Case Manager
Raleigh, NC · Remote
$50K/yr
Valeris works on behalf of life sciences companies to improve the patient experience so that ... Case management or Clinical Trial Nurse experience, a plus. * Bachelor's degree preferred. * Remote ...
Remote Registered Nurse (RN) Case Manager
Raleigh, NC · Remote
$50K/yr
Valeris works on behalf of life sciences companies to improve the patient experience so that ... Case management or Clinical Trial Nurse experience, a plus. * Bachelor's degree preferred. * Remote ...
Remote Insurance Sales Agent - No Experience Needed
Raleigh, NC · Remote
$150K - $200K/yr
... no experience needed) Innovative lead program (mortgage protection, final expense, annuities ... M with automated lead upload Multiple income streams: direct commissions, renewals, and agency ...
Remote Insurance Sales Agent - No Experience Needed
Raleigh, NC · Remote
$150K - $200K/yr
... no experience needed) Innovative lead program (mortgage protection, final expense, annuities ... M with automated lead upload Multiple income streams: direct commissions, renewals, and agency ...
Remote Insurance Sales Agent No Experience Needed
Raleigh, NC · Remote
$150K - $200K/yr
... no experience needed) Innovative lead program (mortgage protection, final expense, annuities ... M with automated lead upload Multiple income streams: direct commissions, renewals, and agency ...
Quick apply
Remote Insurance Sales Agent No Experience Needed
Raleigh, NC · Remote
$150K - $200K/yr
... no experience needed) Innovative lead program (mortgage protection, final expense, annuities ... M with automated lead upload Multiple income streams: direct commissions, renewals, and agency ...
Online Customer Service - No Experience
Raleigh, NC · On-site +1
$90K - $120K/yr
In this fully remote opportunity, you will help individuals and families access important ... Warm leads provided - no cold calling or prospecting * Weekly pay via direct deposit * Full ...
Online Customer Service - No Experience
Raleigh, NC · On-site +1
$90K - $120K/yr
In this fully remote opportunity, you will help individuals and families access important ... Warm leads provided - no cold calling or prospecting * Weekly pay via direct deposit * Full ...
Experience participating in IEP meetings, acting as case manager, and completing comprehensive case ... No-cost continuing education courses and clinical workshops tailored to your professional ...
Quick apply
Experience participating in IEP meetings, acting as case manager, and completing comprehensive case ... No-cost continuing education courses and clinical workshops tailored to your professional ...
... no sales experience. There is no cold calling, our leads system provides you with plenty of leads ... micro-manage them Those unwilling to personally grow and change Benjamin Edson | Regional Sales ...
... no sales experience. There is no cold calling, our leads system provides you with plenty of leads ... micro-manage them Those unwilling to personally grow and change Benjamin Edson | Regional Sales ...
Remote Travel Coordinator
Cary, NC · On-site +1
$47K - $75K/yr
... training - No experience? No problem. We guide you step-by-step • Join a vibrant community ... Manage Bookings - Handle payments, flight changes, seat assignments & client docs 🔹 Stay ...
Remote Travel Coordinator
Cary, NC · On-site +1
$47K - $75K/yr
... training - No experience? No problem. We guide you step-by-step • Join a vibrant community ... Manage Bookings - Handle payments, flight changes, seat assignments & client docs 🔹 Stay ...
UX Designer (Remote)
Cary, NC · On-site +1
$52K - $81K/yr
This role collaborates closely with Engineering, Product Management, Product Training, Client Care ... Must have portfolio showcasing UX/UI work, class projects, or case studies. * Proficiency with ...
UX Designer (Remote)
Cary, NC · On-site +1
$52K - $81K/yr
This role collaborates closely with Engineering, Product Management, Product Training, Client Care ... Must have portfolio showcasing UX/UI work, class projects, or case studies. * Proficiency with ...
Remote Sales
Raleigh, NC · On-site +1
$10K - $20K/wk
No experience? No problem. We provide training, mentorship, and a proven system to help you succeed ... Fully remote, flexible work environment * Growth-focused culture with advancement opportunities ...
Remote Sales
Raleigh, NC · On-site +1
$10K - $20K/wk
No experience? No problem. We provide training, mentorship, and a proven system to help you succeed ... Fully remote, flexible work environment * Growth-focused culture with advancement opportunities ...
SPECIAL NEEDS ADOPTION COORDINATOR
Raleigh, NC · Remote
$48K/yr
Adoption Coordinator (Full-Time | Remote | $48,000) Join Lutheran Services Carolinas and help ... Experience in social work, child welfare, foster care, adoption services, or case management ...
SPECIAL NEEDS ADOPTION COORDINATOR
Raleigh, NC · Remote
$48K/yr
Adoption Coordinator (Full-Time | Remote | $48,000) Join Lutheran Services Carolinas and help ... Experience in social work, child welfare, foster care, adoption services, or case management ...
Remote Case Manager No Experience information
See Raleigh, NC salary details
$14.02 - $16.51
6% of jobs
$18.83 is the 25th percentile. Wages below this are outliers.
$16.51 - $18.99
20% of jobs
The median wage is $21.32 / hr.
$18.99 - $21.48
25% of jobs
$21.48 - $23.96
21% of jobs
$24.58 is the 75th percentile. Wages above this are outliers.
$23.96 - $26.45
9% of jobs
$26.45 - $28.93
5% of jobs
$28.93 - $31.42
4% of jobs
$31.42 - $33.90
3% of jobs
$33.90 - $36.39
2% of jobs
$36.39 - $38.88
2% of jobs
$38.88 - $41.36
1% of jobs
$14
$24
$41
How much do remote case manager no experience jobs pay per hour?
What are remote case managers with no experience?
What are some common challenges faced by remote case managers with no prior experience, and how can they overcome them?
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Full-time
Medical, Dental, Vision, Retirement, PTO
Posted 24 days ago
Job description
A typical day in this role will include ownership of your patient journey from initiation to closure by using your critical thinking skills and your knowledge of the program and industry rules and standards. This includes completing benefit investigations, tracking prior authorizations / denial appeals, and assisting patients or other callers/stakeholders through resolution (via email, inbound/outbound calls and using our patented technology, Lynk). This role requires a strong understanding of pharmacy and medical billing and coding, excellent communication skills, and the ability to navigate complex reimbursement processes.
The Executive Case Manager provides expertise on insurance coverage and common access and reimbursement challenges affecting patients, healthcare providers and clients. The Executive Case Manager responsibilities include education on the access and reimbursement support tools available from PharmaCord and participating program, advising HCPs and/or patients and caregivers on the benefits and program eligibility for a specific patient, and educating HCP offices on Payor processes and procedures.
- Relationship Management
- Builds trusted relationships with patients, prescribers, and appropriate client stakeholders regarding reimbursement inquiries and challenges through proactive communication, timely and accurate execution of deliverables and demonstrated relentless passion for helping patients.
- Manages all relationships in a manner that adheres to all relevant laws, regulations, program-specific operating procedures and industry standards related to access and affordability, including HIPAA and insurance guidelines.
- Managed through call/contact center structure, this role supports inbound and outbound calls to patients, caregivers, specialty pharmacies and healthcare professionals.
- Performs post Benefits Investigation calls to patients and/or physicians explaining coverage options and next steps in the access journey.
- Manages all client inquiries as appropriate, such as case specific statuses.
- Manages HCP inquiries, as applicable, pursuant to business rules.
- All communications with the client’s field teams will remain compliant and adhere to ways of working protocols outlined between PharmaCord and the client teams. Inbound Call Management
- Manages inbound calls as directed by the program-approved FAQs
- Triage patients to internal or external resources as appropriate.
- Personalized Case Management
- Provides personalized case management to patients and HCPs including outbound communication to HCPs, specialty pharmacies and patients to communicate benefit coverage and/or appropriately help drive next steps in obtaining coverage and/or access to prescribed medicine. All communications for case management will follow the guidelines set forth for the program and only provide information publicly available and/or outlined in the patient insert.
- Leverages electronic tools to identify benefits and payer coverage; completes manual benefit investigation as needed.
- Identifies and communicates patient’s plan benefit coverage including the need for prior authorization, appeal, tier exception, and/or formulary exclusions.
- Serves as a subject matter expert to internal team as required and appropriate.
- Uses electronic resources to obtain benefit coverage outcome and if needed, outbound call to payers and HCPs to follow up on proper submission and/or outcome.
- Coordinates nurse teach with nurse educators, as applicable to program.
- Supports adherence services as applicable to program.
- Identifies peer support resources for patients.
- Proactively communicates needs for reverification of prior authorization or re-enrollment.
- Identifies and reports adverse events, product complaints, special situation reports and/or medical inquiries received in accordance with program operating procedures and the Business Rules.
- Documents all activities within the PharmaCord Lynk system, maintaining detailed records of reimbursement activities, including claims status, payments, and appeals.
- Generate reports and analysis as needed to identify trends and opportunities for improvement.in accordance with business requirements.
- Utilize Valeris’ values as the driving force behind the team’s success
- On time adherence to training deadlines for all corporate policies and procedures
- Ensure all SOPs are followed with consistency
- Perform additional tasks or projects as assigned
- Completion of Bachelor's degree (or higher) required
- A degree in healthcare administration, social science or similar related fields is strongly preferred.
- Minimum two years of experience in healthcare access delivery or management is strongly preferred.
- 5-10 years of experience in insurance reimbursement, patient access, direct patient care, and/or patient education experience will be considered in lieu of degree.
- Will consider other certifications and five or more consecutive years of experience in relevant field. Certification examples include PACS (Prior Authorization Certified Specialist), CHES (Certified Health Education Specialist) or CCM in healthcare or social science (Certified Case Manager).
- Strong understanding of medical terminology, coding systems (ICD-10, CPT, HCPCS), and insurance processes.
- Demonstrated examples of executing within guardrails recognizing urgency and consistently delivering patient centric results.
- Excellent attention to detail and organizational skills.
- Ability to prioritize tasks and work efficiently in a fast-paced environment.
- Effective written and verbal communication and interpersonal skills, with the ability to interact professionally with diverse stakeholders.
- Demonstrates the ability to think critically and issue resolution.
- Knowledge of healthcare compliance regulations, including HIPAA and Medicare/Medicaid guidelines.
- Bi-lingual skills are a plus.
- Remote work eligibility is subject to all work from home criteria met and based on business need
- While performing the duties of this job, the employee is regularly required to talk or hear. The employee is frequently required to sit for long periods of time, use hands to type, handle or feel; and reach with hands and arms. Prefer candidates who can type at least 35 words per minute with 97% accuracy.
- Although very minimal, flexibility to travel as needed is preferred.
- This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, etc.
- Medical, dental, and vision plans, including HSA- and FSA-eligible options, with Valeris contributing toward premium costs
- Additional health support, including telehealth and Employee Assistance Program (EAP) services
- Company match on Health Savings Account contributions
- Free Basic Life and AD amp;D coverage equal to your annual earnings, with a minimum of $50,000 and a maximum of $300,000
- Company-paid Short-Term Disability coverage, with the option to purchase Long-Term Disability
- 401(k) Retirement Savings Plan with 100% match on the first 5% you contribute, with immediate vesting
- Paid Time Off (PTO) and Sick Leave to support work-life balance
- Team members receive nine paid holidays plus two floating holidays
- Opportunities for advancement in a company that supports personal and professional growth
- A challenging, stimulating work environment that encourages new ideas
- Work for a company that values diversity and makes deliberate efforts to create an inclusive workplace
- A mission-driven, inclusive culture where your work makes a meaningful impact
Due to an increase in hiring scams, please be aware that if you are selected to move forward in our hiring process, a member of our Talent Acquisition team will contact you directly using an official @pharmacord.com and/or @valeris.com, @echo.newtonsoftware.com email address regarding next steps in our interview process.
Please Note:- PharmaCord will never use Microsoft Teams to reach out to candidates for interview scheduling. However, video interviews are typically conducted via Microsoft Teams. Official meeting links will always be sent from an @valeris.com, @pharmacord.com or @echo.newtonsoftware.com email address, or through our scheduling platform, Calendly.
- We will never request your bank account information at any stage of the hiring process.
- We will never send a check (electronic or physical) to purchase home office equipment.
If you receive any suspicious communication regarding employment with PharmaCord, please report it to our Talent Acquisition team immediately at careers@pharmacord.com