RN: Rx Refill & Prior Auth Specialist, Behavioral Health

St. Luke’s University Health Network; Bethlehem (Northampton County); Hybrid; USD 75.000 - 95.000; Vollzeit

Zusammenfassung

St. Luke's University Health Network seeks a Registered Nurse, Rx Refill and Prior Authorization Specialist within the Behavioral Health Navigation Center.

The role will manage medication refills, prior authorizations, and patient communication with a focus on quality patient experience. You will mentor team members, escalate issues to providers, and collaborate with behavioral health and pharmacy operations to maintain timely access to medications, including complex cases and controlled

Qualifikationen

• Active RN license in PA.
• Graduate of an accredited nursing program.
• Bachelor's degree in nursing preferred.
• Leadership experience is preferred.
• Experience working in patient interactions by phone.

Aufgaben

• Process incoming patient medication refills and prior authorization requests using the EHR and refill platforms.
• Engage patients in a polite, prompt and compassionate manner during all interactions.
• Review records and refill protocols to support filling when flag indicates review.
• Escalate questions to prescribing providers when criteria are not met.
• Coordinate with insurance companies to obtain prior authorizations for medications and procedures.
• Mentor Rx Refill Specialists and collaborate with Behavioral Health Navigation Center.
• Document pertinent information in the medical record and update patients as needed.
• Maintain staffing plans with the Behavioral Health Navigation Center to ensure service levels.

Jobbeschreibung

St. Luke's University Health Network seeks a Registered Nurse, Rx Refill and Prior Authorization Specialist within the Behavioral Health Navigation Center.

The role will manage medication refills, prior authorizations, and patient communication with a focus on quality patient experience. You will mentor team members, escalate issues to providers, and collaborate with behavioral health and pharmacy operations to maintain timely access to medications, including complex cases and controlled