Medication Access & Authorization Specialist

Geisinger; United States; Remote; USD 65,000 - 90,000; Full time

Job summary

Geisinger in the United States seeks a pharmacist to manage prior authorizations and referrals for medications, using third-party payer criteria. You will research and follow up within set timeframes and communicate authorization details to the care team.

You will educate providers and patients about specialty services, assist programs, and help grow the specialty pharmacy patient population. This role may require floating to areas with workload fluctuations while following policies.

Qualifications

• Prior authorization experience with third-party payers.
• Knowledge of third-party payer criteria and eligibility requirements.
• Experience identifying and coordinating patient assistance programs.
• Ability to educate providers and patients on specialty services.

Responsibilities

• Completes prior authorization and documents referrals for medications reviewed using payer criteria.
• Conducts research and follow-up within established timeframes; tracks changes in payer criteria.
• Communicates authorization status and details with the care team.
• Maintains knowledge of patient assistance programs and eligibility requirements.
• Identifies and discusses affordable options with patients and arranges enrollment in assistance programs.
• Ensures accurate completion of necessary paperwork for enrollment in assistance programs.
• Tracks fund award end dates and re-applies to prevent lapses in therapies.
• Helps communicate status of assistance applications to the care team.
• Educates providers and patients on specialty services to improve patient care and grow the specialty pharmacy population.
• Floats to areas of variable workload to provide patient services as needed.
• Adheres to organization policies and job obligations.

Job description

Geisinger in the United States seeks a pharmacist to manage prior authorizations and referrals for medications, using third-party payer criteria. You will research and follow up within set timeframes and communicate authorization details to the care team.

You will educate providers and patients about specialty services, assist programs, and help grow the specialty pharmacy patient population. This role may require floating to areas with workload fluctuations while following policies.