Pharmacy Care Navigator: Fast, Patient-Focused Access

Children's Hospital of Philadelphia; Philadelphia (Philadelphia County); On-site; USD 34,000 - 44,000; Full time

Benefits offered by this job

Influenza vaccination (annual)

Job summary

Children’s Hospital of Philadelphia (CHOP) is seeking a Pharmacy Care Coordinator to ensure timely access to medications by managing benefit verification, prior authorizations, reauthorizations and appeals. You will triage inquiries, explain benefit structures, and document activity in the EHR while collaborating with patients, providers, payors and pharmacies.

As a PCC, you will support CHOP’s mission by ensuring coverage continuity and efficient operations in a fast-paced, team-driven

Qualifications

• High School Diploma or GED required.
• Bachelor’s degree preferred.
• At least two years of related experience preferred.

Responsibilities

• Verify benefits and eligibility for pharmacy or medical benefits.
• Handle prior authorizations, reauthorizations, and appeals.
• Submit and track prior authorizations and appeals.
• Communicate coverage status to patients, families, and providers.
• Document all activities in the EHR.
• Coordinate with providers, clinics, pharmacies, and payors.

Skills

Benefits verification

Prior authorizations

EHR documentation

Interpersonal communication

Pharmacy systems

Detail oriented

Problem solving

Education

High School Diploma / GED

Bachelor's Degree Preferred

Tools

Epic Hyperspace

Epic Willow

HDMS

NaviNet

Surescripts

Job description

Children’s Hospital of Philadelphia (CHOP) is seeking a Pharmacy Care Coordinator to ensure timely access to medications by managing benefit verification, prior authorizations, reauthorizations and appeals. You will triage inquiries, explain benefit structures, and document activity in the EHR while collaborating with patients, providers, payors and pharmacies.

As a PCC, you will support CHOP’s mission by ensuring coverage continuity and efficient operations in a fast-paced, team-driven