Specialty Pharmacist Navigator

Jobtailor; Daytona Beach (FL); On-site; USD 110,000 - 140,000; Full time

Job summary

Jobtailor in Daytona Beach, FL is seeking an experienced Pharmacist to support ambulatory and specialty pharmacy partnerships. The role emphasizes patient profiling, insurance adjudication, and prioritizing prior authorization workflows to optimize patient access.

Responsibilities include interfacing with physician practices, coordinating prescription logistics, and mentoring staff while ensuring compliance with regulatory and organizational policies.

Qualifications

• Current pharmacist license in the appropriate state
• PharmD degree strongly preferred
• 5+ years in community/retail/ambulatory pharmacy or health-system related experience
• Experience in specialty pharmacy and/or prior authorizations is highly desirable
• Proficient in Microsoft Office (Word/Excel/PowerPoint)
• Familiarity with insurance adjudication processes
• Comfortable with clinical data and lab values
• Ability to read/write notes in patient medical records

Responsibilities

• Access physician practices and arrange meetings with key stakeholders
• Demonstrate value of ambulatory pharmacy partnerships to specialty practices
• Ensure prescriptions flow through ambulatory pharmacy and are identified by staff
• Establish patient profiles, including third-party payors and clinical information
• Process prescriptions, including insurance adjudication and product sourcing
• Prepare and submit prior authorization paperwork and manage denials
• Triage limited-distribution or out-of-network prescriptions
• Coordinate prescription pickup/courier delivery with patients
• Follow up with patients to ensure timely refills and address adverse reactions
• Inform physician offices of patient progress and document in EMR
• Maintain relationships with physician offices through periodic visits
• Assist with program financial reporting and data collection
• Cross-train to ambulatory pharmacy and assist staffing, including weekends/holidays
• Provide oversight and direction to associates per policies
• Coach, mentor and develop staff including onboarding

Skills

Insurance adjudication

Prescription processing

Patient profile management

Clinical data analysis

Prior authorization submission

Limited-distribution prescription tri-

Pharmacy dispensing systems

Ambulatory pharmacy operations

Financial advocacy

Patient medical record documentation

Communication

Coaching

Mentoring

Relationship management

Team development

Education

Pharmacist License

PharmD degree strongly preferred

Tools

Microsoft Word

Microsoft Excel

Microsoft PowerPoint

EMR Systems

Job description

• Access physician practices for potential specialty Rx value using available tools and data
• Establish communication with targeted specialty practices and arrange meetings with key stakeholders and decision makers
• Demonstrate the value of ambulatory pharmacy partnerships to specialty practices
• Ensure prescriptions flow through to ambulatory pharmacy and are identified by pharmacy staff
• Establish patient profiles, including third-party payors and clinical information
• Process prescriptions, including insurance adjudication and product sourcing
• Prepare and submit prior authorization paperwork and manage denials
• Triage limited-distribution or out-of-network prescriptions
• Act as a financial advocate by leveraging charitable foundations, state programs, and manufacturer programs
• Coordinate prescription pickup/courier delivery with patients
• Follow up with patients to ensure timely refills and address adverse drug reactions or clinical questions
• Inform physician offices of patient progress and document in EMR as necessary
• Maintain relationships with physician offices through periodic visits and meetings
• Assist with program financial reporting and data collection
• Cross-train to ambulatory pharmacy and assist with staffing needs, including weekends and/or holidays as required
• Provide oversight and direction to associates in accordance with organizational policies and procedures
• Coach, mentor, and develop staff, including new employee onboarding and career development

Requirements

• Current unrestricted pharmacist license in the appropriate state of practice
• PharmD degree strongly preferred
• 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
• Proficient in Microsoft Office, including Word, Excel, and PowerPoint
• Prior experience on pharmacy dispensing systems
• Familiarity with insurance adjudication processes
• Comfortable working with clinical data and lab values
• Ability to read/write notes in patient medical records

Core Competencies

Demonstrates expertise in specialty pharmacy operations, including prior authorization processes, insurance adjudication, and patient management. Proficient in establishing relationships with healthcare providers and advocating for patients through financial assistance programs.

Highest-signal resume keywords

• Current Unrestricted Pharmacist License
• PharmD Degree
• 5+ Years Pharmacy Experience
• Prior Authorization Processing
• Microsoft Office Proficiency

Hard Skills

• Insurance Adjudication
• Prescription Processing
• Patient Profile Management
• Clinical Data Analysis
• Prior Authorization Submission
• Limited-Distribution Prescription Triage
• Pharmacy Dispensing Systems
• Ambulatory Pharmacy Operations
• Financial Advocacy
• Patient Medical Record Documentation

Soft Skills

• Communication
• Coaching
• Mentoring
• Relationship Management
• Team Development

Certifications & Qualifications

• Pharmacist License

Industry Keywords

• Specialty Pharmacy
• Ambulatory Pharmacy
• Community Pharmacy
• Health-System Pharmacy
• Patient Advocacy

Tools & Technologies

• Microsoft Word
• Microsoft Excel
• Microsoft PowerPoint
• EMR Systems