Patient Care Coordinator, Specialty - Evernorth

Position Summary The Patient Care Coordinator is responsible for the timely intake and processing of all incoming cases, acting as a key liaison between patients, caregivers, medical providers, and internal teams. This role ensures accurate coordination of patient deliveries, monitors cases for proper escalation, and performs select activities related to clinical management and refill setup for specialty patients under the supervision of a licensed pharmacist. Responsibilities include completing prescription intake, creating and maintaining patient accounts, and utilizing electronic methods to send and receive information from medical professionals.

Key Responsibilities

• Serve as the primary point of contact between medical providers, insured individuals, and internal teams, primarily via phone and email.
• Gather and verify necessary information to facilitate case processing and patient care coordination.
• Complete prescription intake and maintain accurate patient accounts and medication profiles under pharmacist supervision.
• Review and monitor cases, escalating to appropriate teams based on identified triggers.
• Ensure compliance with established workflows, process documentation, and regulatory requirements.
• Coordinate patient deliveries by communicating with patients, caregivers, and medical staff.
• Make outbound and receive inbound calls to/from patients, caregivers, and medical staff; conduct follow-up calls as directed by a licensed pharmacist.
• Provide support to specialty pharmacy team, including prescription order setup, refill requests, and processing.
• Maintain accurate documentation in patient medical records and work proficiently in work queues.
• Provide excellent internal and external customer service, maintaining a professional and service-oriented approach.
• Act as a conduit of information between specialty pharmacy, operations, and patients, caregivers, or medical professionals.
• Complete assigned daily/weekly tasks accurately and on schedule.
• Perform other duties/tasks as required and assigned.

Skills and Abilities

• Strong customer service and interpersonal skills with a focus on client satisfaction.
• Excellent written and verbal communication skills.
• Ability to manage time efficiently, remain organized, and work independently or in a team environment.
• Maintains confidentiality when handling patient information.
• Demonstrates initiative by presenting ideas and suggestions to management.
• Maintains professionalism and service orientation in all interactions.
• Proficient in Microsoft Suite and familiar with business applications.
• Ability to follow through and complete tasks on schedule while meeting quality standards.

Qualifications

• High School Diploma or GED required
• Pharmacy Technician certification preferred.
• 2 years+ of experience in customer service or claims; prior specialty healthcare experience is a plus.
• Proficiency in English spoken and written
• Strong research, planning, and coordination skills.
• Ability to build relationships across teams and work effectively in a matrix environment.
• Independent problem-solving skills with sound judgment; ability to escalate issues when necessary.

As part of Evernorth Health Services, this role supports CarepathRx within our Pharmacy and Care Delivery organization. Our team focuses on specialty pharmacy and infusion services in partnership with hospitals and health systems. 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. About The Cigna Group Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives. 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. If you require reasonable accommodation in completing the online application process, please email: [email protected] for support. Do not email [email protected] for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances. Apply tot his job Apply To this Job