TEKsystems · 2 weeks ago
Care Manager
TEKsystems is a leading provider of business and technology services, seeking a Care Manager for a fully remote outbound seasonal role. The Care Manager will conduct high-volume outbound calls to payors and pharmacy benefit managers to determine copay support eligibility for commercially insured patients, requiring strong customer service and documentation skills.
Information Technology
Responsibilities
Make outbound PBM/payor calls for copay eligibility throughout the workday; maintain phone engagement up to 95% of the shift while executing the correct outbound campaigns and dispositions
Follow approved Call Guides to ask structured, plan‑identifying questions of PBM agents; use compliant script/verbiage and payor‑call steps
Determine and record the verified plan type: Traditional, Accumulator, Hybrid Accumulator, Maximizer, or Hybrid Maximizer, etc. using program definitions and SOPs
Use PBM‑specific prompts (e.g., BIN/PCN/Group workflows, NPI handling, maximizer screening questions) to obtain the benefit details needed for eligibility determination
Document every interaction accurately and in real time: complete call‑guide fields, outcomes, and notes in the designated CRM/telephony tools before taking/making the next call
Create and manage follow‑up activities/tasks as needed with timely completion
Maintain availability/status discipline in the telephony platform (Available/Ready, appropriate Away Codes, correct outbound campaign selection) to maximize connect time
Adhere to program compliance and quality standards (privacy, script adherence, recorded‑call protocols) and participate in QA monitoring
Collaborate professionally with payor/PBM contacts and internal teams; route inquiries outside program scope through approved channels
Demonstrate courtesy, respect, empathy, and a service‑first mindset on every payor/PBM interaction
Apply active listening and de‑escalation techniques with agents as needed
Uphold workplace conduct guidelines and use only approved systems/channels for communications and documentation
Qualification
Required
Conduct high-volume outbound calls to payors/pharmacy benefit managers (PBMs)
Determine whether commercially insured patients on supported products are eligible for copay support
Maintain phone engagement up to 95% of the shift while executing the correct outbound campaigns and dispositions
Follow approved Call Guides to ask structured, plan-identifying questions of PBM agents
Use compliant script/verbiage and payor-call steps
Determine and record the verified plan type: Traditional, Accumulator, Hybrid Accumulator, Maximizer, or Hybrid Maximizer
Use PBM-specific prompts to obtain the benefit details needed for eligibility determination
Document every interaction accurately and in real time
Create and manage follow-up activities/tasks as needed with timely completion
Maintain availability/status discipline in the telephony platform
Adhere to program compliance and quality standards
Participate in QA monitoring
Collaborate professionally with payor/PBM contacts and internal teams
Demonstrate courtesy, respect, empathy, and a service-first mindset on every payor/PBM interaction
Apply active listening and de-escalation techniques with agents as needed
Uphold workplace conduct guidelines and use only approved systems/channels for communications and documentation
Benefits
Medical, dental & vision
Critical Illness, Accident, and Hospital
401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
Life Insurance (Voluntary Life & AD&D for the employee and dependents)
Short and long-term disability
Health Spending Account (HSA)
Transportation benefits
Employee Assistance Program
Time Off/Leave (PTO, Vacation or Sick Leave)
Company
TEKsystems
At TEKsystems, they understand people. Every year they deploy over 80,000 IT professionals at 6,000 client sites across North America,
H1B Sponsorship
TEKsystems has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
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Trends of Total Sponsorships
2025 (46)
2024 (52)
2023 (33)
2022 (22)
2021 (36)
2020 (53)
Funding
Current Stage
Late StageRecent News
2025-11-19
2025-10-29
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