Patient Care Coordinator, Specialty Pharmacy- Evernorth

The job profile for this position is Customer Service Associate Analyst, which is a Band 2 Senior Contributor Career Track Role. Excited to grow your career? We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply! Our people make all the difference in our success. Serve as the primary coordinator for patient cases, ensuring smooth progression from referral through therapy completion. Support specialty pharmacy operations by completing prior authorization documentation, scheduling medication deliveries, and facilitating document retrieval within required timelines.

Responsibilities

• Provide exceptional customer service in a phone-based environment, offering clear communication and empathetic support.
• Perform claim adjudication tasks including prior authorizations, billing, and eligibility checks, which may require outbound calls.
• Collaborate with pharmacists, technicians, and healthcare professionals to resolve patient issues and maintain continuity of care.
• Conduct welcome calls and outreach to help new patients successfully onboard and establish trust.
• Maintain accurate, organized patient records from initial contact through benefit verification, therapy initiation, follow-up, and case closure.
• Use multiple software platforms to manage authorizations, medication profiles, and patient communication.
• Assist with patient questions and serve as backup during high-volume periods.
• Identify and document case concerns, escalations, or process gaps for leadership review.
• Uphold patient confidentiality and follow internal policies and accreditation standards.
• Complete additional duties as assigned.

Required Qualifications

• High school diploma or equivalent.
• Registered Pharmacy Technician licensure.
• Minimum of 2 years of healthcare or specialty pharmacy experience.
• Strong computer proficiency including Windows, Excel, and Word.
• Comfortable working in a phone-based environment with strong verbal and written communication skills.
• Ability to work independently and collaboratively while staying organized in a fast-paced environment.

Preferred Qualifications

• National Certified Pharmacy Technician (PTCB).
• Preferred licensure in in AL, FL, TN, MT, OH, TX, or NY.
• Willingness to obtain registration in additional states.
• Knowledge of pharmacy terminology, insurance processes, medical terminology, and basic pharmaceutical law.

If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an hourly rate of 20 - 30 USD / hourly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. At The Cigna Group, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year, paid holidays, and leaves of absence. For more details on our employee benefits programs, click here. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. Please note that you must meet our posting guidelines to be eligible for consideration. Policy can be reviewed at this link. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.