Pharmacy Support Liaison - Patient Engagement Team (Hybrid)

University Hospitals

Warrensville Heights (OH)

Hybrid

USD 52,000 - 70,000

Full time

14 days+

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Benefits offered by this job

Sign on bonus

Job summary

University Hospitals is seeking a Pharmacy Support Liaison to optimize intake and reimbursement for high-cost medications and home care services. The role involves verifying benefits, obtaining necessary prior authorizations, and coordinating with clinical teams to secure documentation for service initiation.

The position emphasizes improving patient access, minimizing therapy interruptions due to insurance issues, and supporting revenue cycle improvements within UH Meds.

Qualifications

Knowledge of Medicare/Medicaid regulations and commercial insurer criteria for payment of home care services.
Experience with patient assistance programs and third-party payer billing.
Strong familiarity with PHI handling and HIPAA compliance.

Responsibilities

Handle intake and verify insurance benefits for Home Care Pharmacy services.
Perform prior authorizations and obtain initial authorizations for visits from insurers.
Coordinate with pharmacists, RN coordinators, and clinic staff to ensure documentation before acceptance.
Enter data into pharmacy systems and support revenue cycle initiatives.
Respond to patient inquiries and assist with enrollment in patient assistance programs.

Skills

Medicare/Medicaid

Insurance verification

Prior authorizations

PHI compliance

Education

High School Equivalent / GED

Bachelor's Degree in health care related or business field

Job description

The team requires a highly motivated, energetic, team player who is responsible for completing necessary functions to ensure optimal intake and reimbursement for high cost and infusion medications for patients receiving care within the UH Meds enterprise of pharmacy operations. The Pharmacy Support Liaison must have a strong knowledge of Medicare and Medicaid regulations and commercial insurer criteria for payment of home care services. Additionally, they will be responsible for verification of insurance, and benefits for Home Care Pharmacy services - inclusive of new referrals and therapy changes, adjudication of claims and obtaining the initial authorization for visits from commercial insurers. This position will work with Home Care RN Coordinators, Pharmacist and other clinical teams to ensure that required clinical documentation is obtained prior to acceptance onto service. They will also enters pertinent information into the pharmacy and/or certified home health software systems used by the enterprise. The position works closely with and is a supportive role to the Transition Specialist, Clinic Based/Distributional Pharmacists, Central Intake RN's and the Document Control Specialist.

Sign on bonus: $3,000!!

What You Will Do

Access care management documentation systems for data entry and to support the existing programs and processes by collecting information, utilizing appropriate department policies, procedures and guidelines specific to members’ eligibility, benefits and contracts.
Perform intake of service requests from providers or members received electronically, or via telephone or fax.
Triage and respond to incoming phone calls providing information and assistance to meet the caller’s needs.
Authorize service(s) based on plan design or clinical guidelines in accordance with the department policies/guidelines.
Improve patient service experience and maximize pharmacy revenue through provision of prior authorization services on behalf of patients needing high cost medications.
Conduct patient insurance, benefits and financial investigation and verification by directly communicating with patients. Complete initial and renewal prior authorization forms, negotiate authorization status with insurers, track status of medication approval, and when necessary, alert stakeholders of denials or nonresponse.
Identify patient needs and ensure coverage of medication on their insurance plan through benefits investigation. If not covered, obtain necessary information from medical record, patient, and provider to enable justification for Patient Assistance program or copay assistance. Contact patients to provide information related to these resources.
Facilitate enrollment of patients in patient assistance programs and collaborate with social services and case management on patient assistance. Assist pharmacists with preparing letters of medical necessity and coordinating peer-to-peer conferences.
Expedite pharmacy workflow and enhance patient care by preventing therapy interruptions due to insurance issues in conjunction with pharmacists, physicians, transition care coordinators, nursing, and clinic staff. Communicate and collaborate regarding patient therapy interruptions, additional therapy monitoring requirements, and alternative care delivery setting options.
Participate in revenue cycle committees to help identify causes of denied claims and develop workflow solutions to optimize revenue capture
Facilitate staff training and competency, education and practice advancement
Train new staff members
Maintain a training and competency program for all staff that meets accreditation standards
Coordinate with Pharmacy leadership to develop training experiences/competencies
Represent the department at hospital meetings, committees, and events as requested
Patient Engagement Tele pharmacy Support:
Answer incoming calls and respond to electronic communications
Assist health care providers and patients by greeting them by phone; answering questions and requests; referring inquiries to the site pharmacist(s) as needed.
Handle customer inquiries both telephonically and by email
Research required information using available resources
Manage and resolve customer complaints

Additional Responsibilities

Performs other duties as assigned.
Complies with all policies and standards.
For specific duties and responsibilities, refer to documentation provided by the department during orientation.
Must abide by all requirements to safely and securely maintain Protected Health Information (PHI) for our patients. Annual training, the UH Code of Conduct and UH policies and procedures are in place to address appropriate use of PHI in the workplace.

Primary Location

United States-Ohio-Warrensville_Heights

Work Locations

4510 Richmond Road

Organization

UHMeds_Spec_Pharm

Schedule

Full-time

Employee Status

Regular

Job Type

Standard

Job Level

Professional

Travel

Yes, 10 % of the Time

Remote Work

Hybrid

Job Posting

Sep 28, 2026, 10:52:58 AM

Education

High School Equivalent / GED (Required)
Bachelor's Degree in health care related or business field (Preferred)

Work Experience

3+ years Strong clinical background experience in a medical office or other health care setting (Required)

Knowledge, Skills, & Abilities

Knowledge of medical terminology and ICD9, ICD10, CPT, and DRG codes (Required proficiency)
Knowledge of third-party insurance billing practices, federal and state regulations with regard to billing and reimbursement, internal billing structure, and billing procedures (Required proficiency)
Experience with patient assistance programs (Required proficiency)

Licenses and Certifications