Pharmacy Patient Care Case Manager

Job overview

The Pharmacy Patient Care Case Manager role is primarily remote, with occasional onsite collaboration at OptiMed’s headquarters in Kalamazoo, MI; compensation is not specified. OptiMed Health Partners coordinates personalized care across retail pharmacy, specialty pharmacy, and infusion services. The case manager coordinates patient placement and transitions among infusion settings while working with patients, providers, pharmacies, and health plans. The role supports timely therapy, continuity of care, appropriate reimbursement, and positive patient outcomes through case management and provider agreement negotiations.

What you'll do

• Assess clinical, financial, geographic, and benefit factors to determine infusion site of care
• coordinate transitions among hospital outpatient, home infusion, ambulatory, physician office, and health system settings
• collaborate with patients, caregivers, and providers to support therapy
• monitor cases and resolve access barriers
• negotiate reimbursement rates, service agreements, single-case agreements, and letters of agreement
• review contractual terms
• maintain case and negotiation records
• track performance indicators
• participate in quality improvement.

What we're looking for

Skills & competencies

pharmacy patient care case manager

kalamazoo mi

optimed health partners

remote

occasional onsite

infusion care

site-of-care coordination

provider relations

contract negotiation

patient advocacy

reimbursement

specialty pharmacy

Work arrangement

• Weekend coverage required

Why this role

Requires 3–5+ years of experience in healthcare case management, specialty pharmacy, infusion services, provider relations, managed care, or healthcare contracting, including contract or reimbursement review. A related bachelor’s degree, clinical credential, and case management certification are preferred.

About the employer

Optimed Pharmacy Inc is hiring for this role. Industry: All Other Miscellaneous Ambulatory Health Care Services. Sector: 62.