Ambulatory Specialty Pharmacy Care Navigator

Baptist Health; Elizabethtown (KY); On-site; USD 42,000 - 55,000; Full time

Job summary

Baptist Health Hardin in Elizabethtown, KY is seeking a Specialty Pharmacy Care Coordinator to support access to high-touch, complex medication therapies within the Cardiology team.

You will complete benefits investigations, assist with prior authorizations, enroll patients in assistance programs, coordinate with insurers, clinicians, and social workers, and document care activities in the electronic health record.

Qualifications

• High school diploma or equivalent.
• Registration with Kentucky Board of Pharmacy upon hire date.
• Pharmacy technician experience required.
• Prior experience with third party billing, financial counseling, or medical terminology and coding preferred.
• Prior experience with Epic electronic medical record preferred.

Responsibilities

• Completes benefit investigations to verify patient eligibility for prescribed specialty medications.
• Maintains current knowledge of payer formularies and reimbursement.
• Engages in personal development to stay updated with pharmacy trends related to role and practice setting.
• Supports third party prior authorization process and obtain appropriate overrides to improve speed to therapy for new patients.
• Maintains accurate insurance information and monitor for prior authorization renewal needs to avoid gaps in medication therapy
• Triages patient or caregiver clinical questions, medication related concerns, and third-party insurance denials to the pharmacist for intervention as appropriate.
• Utilizes Electronic Health Record to maintain communication between departments and ensure accurate documentation of patient care activities.
• Communicates and represents pharmacy effectively throughout all levels of the organization.
• Serves as the primary point of contact with patients related to specialty medication needs and shows empathy and compassion to patients and caregivers.
• Serves as a liaison with physicians, nurse practitioners, physician assistants, pharmacists, nurses, and social workers to provide administrative support, communicate changes in medication related coverage and regulatory mandates.
• Facilitates enrollment of patients in patient assistance programs to maximize copay savings and assist with gathering appropriate documentation.
• Utilizes technology to organize daily outreach tasks to complete prescription refills, delivery coordination, and claim processing on time.

Skills

Pharmacy technician experience

Prior authorization processes

Billing and reimbursement knowledge

Medical terminology

Interdepartmental collaboration

Education

High school diploma or equivalent

Registration with Kentucky Board of Pharmacy

Tools

Epic EMR

Job description

Baptist Health Hardin in Elizabethtown, KY is seeking a Specialty Pharmacy Care Coordinator to support access to high-touch, complex medication therapies within the Cardiology team.

You will complete benefits investigations, assist with prior authorizations, enroll patients in assistance programs, coordinate with insurers, clinicians, and social workers, and document care activities in the electronic health record.