Specialty Pharmacist Navigator

MWI Buying Group; Chicago, Northern (IL, KY); Hybrid; USD 74,000 - 147,000; Full time

Job summary

Cencora seeks a pharmacist to coordinate ambulatory pharmacy partnerships in the greater Chicago area. The role involves engaging specialty practices, processing prescriptions, and maximizing patient access through insurance adjudication and prior authorizations.

Hybrid work across Chicago, Hinsdale and Westchester areas is offered, with some remote work. A PharmD and active license are preferred, plus 5+ years in relevant pharmacy settings and experience with specialty drugs.

Qualifications

• PharmD degree strongly preferred.
• Active pharmacist license in the appropriate state of practice.
• 5+ years community/retail/ambulatory pharmacy or health-system related experience.
• Experience in specialty pharmacy and/or processing prior authorizations is highly desirable.

Responsibilities

• Access physician practices for potential specialty Rx value using tools/data available.
• Establish communication with targeted specialty practices, arranging meetings with key stakeholders/decision makers.
• Demonstrate value of ambulatory pharmacy partnership to specialty practices.
• Ensure prescriptions flow through to ambulatory pharmacy and are identified by pharmacy staff.
• Establish patient profiles, including third-party payor(s) and clinical information.
• Process prescriptions, including insurance adjudication and product sourcing.
• Prepare and submit prior authorization paperwork; manage denials.
• Triage prescriptions which are limited distribution drugs or out-of-network.
• Act as financial advocate for patient where needed; leverage charitable foundations, state programs, and/or manufacturer programs to ensure maximal patient access.
• Coordinate pickup/courier delivery of Rx's with patient.
• Maintain auditable records showing proof-of-delivery.
• Follow up with patient to ensure refills are ordered on time and address and ADR's or clinical questions.
• Inform physician office of patient through process; document in EMR as necessary.
• Maintain relationships with physician offices through periodic visits/meetings.
• Assist with program financial reporting to client/data collection.
• Cross-train to ambulatory pharmacy; assist with staffing needs as required.

Skills

Microsoft Office

Pharmacy dispensing systems

Insurance adjudication processes

Clinical data interpretation

Education

PharmD degree

Active pharmacist license

Tools

Dispensing software

EMR systems

Job description

Our team members are at the heart of everything we do. At Cencora, we are united in our responsibility to create healthier futures, and every person here is essential to us being able to deliver on that purpose. If you want to make a difference at the center of health, come join our innovative company and help us improve the lives of people and animals everywhere.

Ce que vous ferez

• Access various physician practices for potential specialty Rx value using tools/data available.
• Establish communication with targeted specialty practices, arranging meetings with key stakeholders/decision makers.
• Demonstrate value of ambulatory pharmacy partnership to specialty practices.
• Ensure prescriptions flow through to ambulatory pharmacy and are identified by pharmacy staff.
• Establish patient profiles, including third-party payor(s) and clinical information.
• Process prescriptions, including insurance adjudication and product sourcing.
• Prepare and submit prior authorization paperwork; manage denials.
• Triage prescriptions which are limited distribution drugs or out-of-network.
• Act as financial advocate for patient where needed; leverage charitable foundations, state programs, and/or manufacturer programs to ensure maximal patient access.
• Coordinate pickup/courier delivery of Rx's with patient.
• Ensure auditable records showing proof-of-delivery are maintained.
• Follow up with patient to ensure refills are ordered on time and address and ADR's or clinical questions.
• Inform physician office of patient through process; document in EMR as necessary.
• Maintain relationships with physician offices through periodic visits/meetings.
• Assist with program financial reporting to client/data collection.
• Cross-train to ambulatory pharmacy; assist with staffing needs as required. This may include weekends and/or holidays as per business needs.
• Provide oversight and direction to associates in accordance with the organization’s policies and procedures.
• Coach, mentor, and develop staff, including overseeing new employee onboarding and providing career development and opportunities.

Location

This is a hybrid role across the greater Chicago, Hinsdale, & Westchester areas of Illinois, with remote work weighted more heavily than on-site work.

Education

• PharmD degree strongly preferred.
• Current unrestricted pharmacist license in the appropriate state of practice.
• 5+ years community/retail/ambulatory pharmacy or health-system related experience.
• Previous experience in a specialty pharmacy and/or processing prior authorizations is highly desirable.

Skills and Knowledge

• Must be proficient in Microsoft Office, including Word, Excel, and PowerPoint.
• Candidates should have prior experience on pharmacy dispensing systems and be familiar with insurance adjudication processes.
• The role involves working with a broad array of complex disease states and medical conditions; candidates should be comfortable working with clinical data, lab values, and reading/writing notes in patient medical records.

Salary Range

Salary Range* $73,600 - 147,290 *This Salary Range reflects a National Average for this job. The actual range may vary on your locale. Ranges in Colorado/California/Washington/New York/Hawaii/Vermont/Minnesota/Massachusetts/Illinois State-specific locations may be up to 10% lower than the minimum salary range, and 12% higher than the maximum salary range.

Affiliated Companies

Value Apothecaries Inc

About the Company

Cencora is a leading global pharmaceutical solutions company that is committed to improving the lives of people and animals everywhere. We connect manufacturers, providers, and patients to ensure that anyone can get the therapies they need, where and when they need them. We’re a purpose-driven organization, where all of our team members around the world are united in our responsibility to create healthier futures. We work together every day to help our partners bring their innovations to patients worldwide, creating unparalleled access and impact at the center of health.