Case Management- LDD

Alivia Health, LLC; Guaynabo (PR); On-site; USD 42,000 - 62,000; Full time

Job summary

Alivia Health, LLC is seeking a Case Manager- LDD in Guaynabo, PR to review prescriptions, coordinate patient communications, and manage documentation under LDD contracts. The role requires a Pharmacy Technician license and an associate degree, with preference for specialty pharmacy experience.

Responsibilities include patient outreach, billing liaison, and ensuring timely drug delivery while adhering to state and federal regulations. Bilingual English/Spanish required.

Qualifications

• Excellent written and verbal communications in English and Spanish.
• Experience in specialty pharmacy is preferred.
• Valid license as Pharmacy Technician is required.
• Specialized training in access to pharmacy/medical benefits is required.

Responsibilities

• Review and interpret doctor's prescription orders to ensure appropriate therapies.
• Transcribe prescription data for pharmacist verification.
• Inform new patients about prescription referrals and welcome them to Alivia Specialty Pharmacy.
• Review patient records, including medication lists for DUR research.
• Communicate with HUB to manage prescriptions per LDD contract.
• Coordinate with patients and medical offices for documentation and drug delivery.
• Track insurance claims and communicate cost of therapy to patients.
• Identify assistance programs under LDD contract and assist enrollment.
• Follow up on patient refills to ensure timely delivery and therapy continuity.
• Meet production standards and comply with laws and internal policies.

Skills

Bilingual English/Spanish

Pharmacy coordination

Verbal communication

Education

Associate Degree Diploma as Certified Pharmaceutical Technician

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Case Management- LDD

Limited Distribution Drugs Full Time GUAYNABO, PR, US

LDD Case Manager will be responsible for the following tasks:

• Review and interpret doctor's prescription orders to ensure appropriate therapies.
• Transcribe prescription data in preparation for pharmacist verification.
• Communicate with all new patients informing them of prescription referrals and welcoming them to the Alivia Specialty Pharmacy.
• Complete and review patient record information with each prescription, including the patient's medication list for DUR research.
• Communicate with HUB if the LDD contract establish as required to manage the prescriptions.
• Communicate with patients and HCP offices to ensure all documentation required for timely prescription is made available
• Award and review prescription drug insurance claims that will be delivered to patients and providers.
• Communicate with health plans to obtain prescriptions status and/or approval. Also include, any modified authorization if required.
• Identify and process foundations and/or assistance programs required per LDD contract.
• Communicate with patient any cost of therapy after approval.
• Coordinate with patient and medical offices the drug deliver. Includes any supplemental materials required by LDD contract.
• Follow up patient refills for on time drug deliver. Including, new prescriptions required for therapy continuity.
• Complete any documentation required per LDD contract.
• Refer to Alivia Clinical Programs any clinical intervention required by LDD contract.
• Meet management's production standards, whether quantitative or qualitative.
• Perform work assignments in full compliance with and understanding of state and federal laws, as well as the internal policies and procedures that govern the handling, dispensing and distribution of controlled substances.
• Associate Degree Diploma as Certified Pharmaceutical Technician is required.
• Valid license as Pharmacy Technician is required.
• Specialized training in access to pharmacy / medical benefits and requirements is required.
• Experience in Specialty Pharmacy preferred.
• Excellent written and verbal communications (English and Spanish) is required.

***Equal Opportunity Employer F/M/D/V***