Third Party Liaison

From intake to outcomes, CareMetx is dedicated to delivering industry-leading patient access solutions and support services that help patients quickly start and stay on specialty therapy treatments. We provide scalable, efficient digital hub services for pharmaceutical companies and healthcare providers, streamlining workflows with seamless integration for patient enrollment, consent, and prior authorization. Our best-in-class patient support services enhance every step of care, connecting patients, providers, and brands to drive better outcomes and accelerate time-to-therapy.

Job Title: Third Party Liaison

POSITION SUMMARY:

The Third Party Liaison serves as a liaison between the operations program(s) and third party vendors of the manufacturer. Vendors could include but not limited to specialty pharmacies, data aggregators, and other service providers. The Third Party Liaison proactively monitors program reports to assess adherence to business requirements and ensures that services are coordinated in a way that manufacturer expectations are met.

PRIMARY DUTIES AND RESPONSIBILITIES:

• Lead and facilitate calls with 3rd party contacts (and client, if applicable) to monitor patient progress, reconcile data discrepancies, research missing data, handle inquiries and provide update as requested.
• Create and maintain action log, agendas and minutes for each meeting they lead.
• Handle inbound/outbound calls from all applicable customers including but not limited to 3rd party contacts, client contacts, third party vendors and internal team resources.
• Triage and/or approve work referrals to 3rd parties as needed.
• Reference and implement business requirements as it pertains to operations procedures, validation of incoming data from the 3rd party, and identifying and escalating data feed issues internally and externally.
• Identify needed system enhancements and/or reports and participate in requirement review, testing and implementation.
• Implement business requirements for newly contracted 3rd party interfacing with the programs(s) supported to ensure adherence to all contractual obligations; ensure all data is validated prior to program launch.
• Share best practices and learning opportunities with program implementations and peers.

Qualifications

EXPERIENCE AND EDUCATIONAL REQUIREMENTS:

• High school diploma or GED required.
• Requires a minimum of five (5) years directly related and progressively responsible experience in project coordination, customer service,
• medical billing and coding, benefits verification, healthcare, business administration or similar vocations.
• Bachelor’s degree preferred.
• An equivalent combination of education and experience will be considered

MINIMUM SKILLS, KNOWLEDGE AND ABILITY REQUIREMENTS:

• Ability to communicate effectively both orally and in writing to a variety of audiences.
• Ability to collaborate and influence with internal and external stakeholders.
• Strong interpersonal skills.
• Ability to plan, prioritize and work independently while giving strong attention to detail.
• Advanced organizational skills and attention to detail.
• Advanced knowledge of pharmacy operations and medical claims.
• Strong use of medical industry vernacular.
• General knowledge of health care billing required, advanced preferred.
• Advanced proficiency with Microsoft Office to include Excel, PowerPoint, Word and Outlook. Knowledge of computer database systems and functionality.
• Developing professional expertise; applies company policies and procedures to resolve a variety of issues.

Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• While performing the duties of this job, the employee is regularly required to sit.
• The employee must occasionally lift and/or move up to 10 pounds.

Work Environment:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate.

Schedule:

• Must be flexible on schedule and hours.
• Some Travel may be required.

CareMetx considers equivalent combinations of experience and education for most jobs. All candidates who believe they possess equivalent experience and education are encouraged to apply.

At CareMetx we work hard, we believe in what we do, and we want to be a company that does right by our employees. Our niche industry is an integral player in getting specialty products and devices to the patients who need them by managing reimbursements for those products, identifying alternative funding when insurers do not pay, and providing clinical services.

CareMetx is an equal employment opportunity employer. All qualified applicants will receive consideration for employment and will not be discriminated against based on race, color, sex, sexual orientation, gender identity, religion, disability, age, genetic information, veteran status, ancestry, or national or ethnic origin.

Artificial Intelligence in Our Recruiting and Employment Process

CareMetx uses artificial intelligence and automated decision-making technology to support parts of our recruiting, hiring, and employment process, including screening applications, scheduling interviews, and evaluating candidate qualifications. These tools support, not replace, human judgment. A qualified member of our team reviews and makes all final hiring and employment decisions.

CareMetx does not develop or use AI tools with the intent to discriminate against applicants or employees on the basis of race, color, religion, sex, age, sexual orientation, national origin, disability, veteran status, or any other protected characteristic.