Sr. Coordinator, Individualized Care (Case Manager)
Please mention DailyRemote when applying
AI Summary
What Individualized Care contributes to Cardinal Health
Clinical Operations is responsible for providing clinical specialties support and expertise in the areas of advice and consulting, research and patient care to internal business units and external customers.
Individualized Care provides care that is planned to meet the particular needs of an individual patient.
Key Responsibilities
- Provide end to end claims support including submission guidance, tracking, resolution, billing and coding support, and reimbursement assistance.
- Serve as a primary provider contact, validating claim requirements, supporting clean resubmissions, and driving timely reimbursement outcomes.
- Review denied claims, identify the root cause of denial, and provide clear correction guidance for provider resubmission.
- Track status and follow up with payers as required, maintaining a consistent cadence to drive resolution.
- Support prior authorization requirements and assist with appeals processes when coverage is denied, guiding providers on payer requirements and next steps.
- Support workflows that provide reimbursement to providers via electronic fund transfer when immunizations are not covered and all attempts to secure a paid claim have been exhausted, in alignment with program business rules.
- Process enrollments received through digital and assisted channels, including portal intake and IVR or live agent support, and maintain accurate case documentation and communications in CRM.
- Provide world class service across inbound and outbound interactions with provider offices and other stakeholders, striving for efficient resolution and professional de-escalation when needed.
- Maintain complete, compliant documentation, ensuring accurate capture of insurance, coverage approvals, ongoing coverage requirements, and interaction notes.
- Identify and report Adverse Events
- Collaborate with internal and external partners, using root cause analysis to resolve access barriers and sharing learnings with the team to improve processes and outcomes.
- Contribute to program readiness by supporting work instructions, SOP adherence, and training adoption as requirements evolve.
- Strong provider facing communication, problem solving, and documentation discipline.
- Ability to manage time sensitive work, prioritize effectively, and drive follow through to resolution.
- Comfort with data driven workflows and CRM based case management.
- Claims investigation completion timeliness and quality.
- Missing information outreach and collection timeliness.
- Provider relay results timeliness following claim investigation completion.
- Customer service quality monitoring scores and customer satisfaction performance.
Required Qualifications
- 3-6 years of experience, preferred
- High School Diploma, GED or equivalent work experience, preferred
- Demonstrated experience in reimbursement support services, benefit investigation, claims, prior authorization, appeals, or similar healthcare access functions.
- Ability to work in a changing environment and maintain resiliency as systems and requirements evolve.
Preferred Qualifications
- Experience guiding providers through claims correction and resubmission processes.
- Experience working with medical and pharmacy benefit payers and navigating payer specific rules.
- Experience supporting immunization, buy and bill, or medical benefit claim workflows.
- Prior hub or patient support services experience supporting provider reimbursement workflows.
- Strong people skills that demonstrate flexibility, persistence, creativity, empathy, and trust.
- Robust computer literacy skills including data entry and MS Office-based software programs.
- Ability to identify and handle sensitive issues, working independently and collaboratively within teams.
- Consistently demonstrates effective utilization and application of resources.
- Ability to work independently, prioritize effectively, and thrive in a fast-paced, dynamic environment.
- Excellent interpersonal and communication skills, with a collaborative team mindset.
- Demonstrates a high level of adaptability and openness to new ideas, with a proven ability to embrace change and thrive in dynamic environments.
- Proficiency in managing data and analytics tools is a plus.
Bi-lingual; Spanish language skills preferred.
What is expected of you and others at this level
- Effectively applies knowledge of job and company policies and procedures to complete a variety of assignments
- In-depth knowledge in technical or specialty area
- Applies advanced skills to resolve complex problems independently
- May modify process to resolve situations
- Works independently within established procedures; may receive general guidance on new assignments
- May provide general guidance or technical assistance to less experienced team members
TRAINING AND WORK SCHEDULES: Your new hire training will take place 8:00am-5:00pm CT, mandatory attendance is required.
This position is full-time (40 hours/week). Employees are required to have flexibility to work any of our shift schedules during our normal business hours of Monday-Friday, 9:00am- 8:00pm ET.
REMOTE DETAILS: All U.S. residents are eligible to apply to this position. You will work remotely, full-time. It will require a dedicated, quiet, private, distraction free environment with access to high-speed internet. We will provide you with the computer, technology and equipment needed to successfully perform your job. You will be responsible for providing high-speed internet. Internet requirements include the following:
Maintain a secure, high-speed, broadband internet connection (DSL, Cable, or Fiber) at the remote location. Dial-up, satellite, WIFI, Cellular connections are NOT acceptable. Download speed of 15Mbps (megabyte per second)
- Upload speed of 5Mbps (megabyte per second)
- Ping Rate Maximum of 30ms (milliseconds)
- Hardwired to the router
- Surge protector with Network Line Protection for CAH issued equipment
Anticipated hourly range: $21.40 per hour - $30.60 per hour
Bonus eligible: No
Benefits: Cardinal Health offers a wide variety of benefits and programs to support health and well-being.
Medical, dental and vision coverage
Paid time off plan
Health savings account (HSA)
401k savings plan
Access to wages before pay day with myFlexPay
Flexible spending accounts (FSAs)
Short- and long-term disability coverage
Work-Life resources
Paid parental leave
Healthy lifestyle programs
Application window anticipated to close: 8/8/26* if interested in opportunity, please submit application as soon as possible.
The hourly range listed is an estimate. Pay at Cardinal Health is determined by multiple factors including, but not limited to, a candidate’s geographical location, relevant education, experience and skills and an evaluation of internal pay equity.
Candidates who are back-to-work, people with disabilities, without a college degree, and Veterans are encouraged to apply.
Cardinal Health supports an inclusive workplace that values diversity of thought, experience and background. We celebrate the power of our differences to create better solutions for our customers by ensuring employees can be their authentic selves each day. Cardinal Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, ancestry, age, physical or mental disability, sex, sexual orientation, gender identity/expression, pregnancy, veteran status, marital status, creed, status with regard to public assistance, genetic status or any other status protected by federal, state or local law.
To read and review this privacy notice click here
Automatically Apply to the Best Remote Jobs
Stop the endless job search. Our AI finds and applies to the best jobs for you.
