Patient Lifecycle Coordinator

CORE JOB SUMMARY

The Patient Lifecycle Coordinator is responsible for overseeing the for overseeing the patient's full care journey from intake through medication delivery across both community and correctional sites, serving as the central point of contact for telehealth and referral coordination. This person ensures seamless end-to-end coordination — intake, scheduling, insurance verification and prior authorization, and medication delivery — while maintaining proactive communication with correctional facility and community partner sites regarding scheduling changes and medication delivery status. This role works closely with the Patient Life Cycle Manager, pharmacy team, and clinical team to ensure no gaps exist between referral, authorization, and service delivery..

CORE JOB FUNCTIONS

1. Serve as the central point of contact for telehealth and referral coordination, guiding patients through their full care journey from intake to medication delivery.
2. Monitor and manage patient intake, scheduling, and follow-up appointments across community and correctional sites via EMR and telehealth platforms.
3. Review and process prior authorization requests for medications, medical procedures, and treatments, and verify patients' insurance eligibility, benefits, and coverage requirements.
4. Monitor and follow up on pending insurance applications, prior authorizations, appeals, and reconsiderations, providing timely updates to providers and internal stakeholders.
5. Coordinate care transitions, referrals, and medication delivery logistics, ensuring the site is informed of scheduling changes and delivery status in real time.
6. Communicate with healthcare providers, pharmacies, and insurance companies to obtain required clinical and insurance information, and to resolve authorization or coverage issues.
7. Perform case documentation, complete assessments (e.g., STI/HIV risk, Hepatitis C), and track patient outcomes throughout the care journey.
8. Ensure all documentation is complete, accurate, and meets payer requirements before submission; submit prior authorization requests within required turnaround times.
9. Communicate professionally with correctional facility contacts, community partner sites, providers, and internal staff via phone, email, and messaging platforms.
10. Collaborate closely with the clinical team to resolve authorization, scheduling, and coverage issues and ensure coordinated service delivery.
11. Analyze patient flow and identify bottlenecks or gaps across intake, authorization, and delivery, escalating as needed.
12. Maintain patient confidentiality and ensure compliance with HIPAA and organizational policies.
13. Stay current on payer policies, authorization requirements, formularies, and industry guidelines to ensure compliance and maximize approval rates.

This list of duties and responsibilities is not intended to be all-inclusive and may be expanded to include other duties or responsibilities as necessary.