Pharmacy Care Coordinator II

BHS

Richmond (VA)

On-site

USD 42,000 - 68,000

Full time

14 days+

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Benefits offered by this job

Health, Vision, Dental and Pet Insider

Life Insurance

Short Term and Long-Term Disability

Identity Theft Protection

Tuition Reimbursement up to $6,000

Company paid Maternity and Paternity <

5 days of Paid Time Off available upon

Bereavement Leave (includes pets)

PTO Sell Back Program

Compassionate Leave Sharing Program (P

Job summary

Baptist Health in Richmond, VA is seeking a Specialty Pharmacy Care Coordinator to support ambulatory clinic teams in obtaining authorizations and coordinating specialty medication care.

Under pharmacist supervision, you will handle benefits investigations, prior authorizations, patient outreach, and enrollment in patient assistance programs while maintaining accurate documentation in the EHR and delivering compassionate, patient-centered service.

Qualifications

High School or GED required.
Registration with Kentucky Board of Pharmacy on hire date.
National Pharmacy Technician Certification required.
BLS required.

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.
Serves as the primary point of contact with patients related to specialty medication needs and shows empathy and compassion to patients and caregivers.
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.
Demonstrates commitment to the quality, philosophy, and values of Baptist Health by maintaining compliance with established policies and procedures, organizational objectives, process improvement, and safety standards.

Education

High School or GED Required

Registration with Kentucky Board of Pharmacy

National Pharmacy Technician Certification

BLS

Job description

Job Description:

The Specialty Pharmacy Care Coordinator acts as an extension of the ambulatory clinic teams to support patient access to high touch, complex medication therapies. This position is based in a centralized specialty pharmacy call center setting under pharmacist supervision. The Specialty Pharmacy Care Coordinator functions in a multi-skilled environment which requires the application of teamwork, leadership and flexibility. Works in collaboration with insurance companies, nursing, and social workers to obtain appropriate authorization for medications including registration with drug specific manufacturer programs when applicable. Performs tasks related to prescription billing including completing benefits investigations, assisting with the prior authorization process, and locating copay assistance options for patients to ensure affordability of specialty medications. Assists with call center intervention outcomes tracking to monitor value of services. Coordinates telephonic patient outreach for new and enrolled patients to ensure continuity of care and optimize patient outcomes.

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.
Serves as the primary point of contact with patients related to specialty medication needs and shows empathy and compassion to patients and caregivers.
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.
Demonstrates commitment to the quality, philosophy, and values of Baptist Health by maintaining compliance with established policies and procedures, organizational objectives, process improvement, and safety standards.

Essential Qualifications: