Specialty Pharmacy Care Coordinator

BHS Baptist Healthcare System; Kentucky; On-site; USD 40,000 - 60,000; Full time

Job summary

Baptist Health in LaGrange, KY, is seeking a Specialty Pharmacy Care Coordinator to join the Central Pharmacy team. You will complete benefit investigations, verify eligibility for specialty meds, and support the prior authorization process to speed therapy for new patients.

You will work with physicians, nurses, social workers, and the pharmacy to ensure accurate insurance data, manage copay assistance, and coordinate outreach to patients to optimize care outcomes.

Qualifications

• Pharmacy technician experience or related pharmacy duties required.
• Registration with Kentucky Board of Pharmacy on hire date.
• Experience with third party billing, financial counseling, or medical terminology preferred.
• Epic EMR experience preferred.

Responsibilities

• Conduct benefit investigations to verify patient eligibility for prescribed specialty medications.
• Assist with third party prior authorization processes and obtain needed overrides.
• Maintain insurance information and monitor for renewal needs to avoid gaps in therapy.
• Coordinate patient outreach during clinic visits or telephonic follow-ups to ensure continuity of care.

Skills

Pharmacy knowledge

Customer service

Education

High school diploma or equivalent

Tools

Epic EHR

Job description

Summary

The Pharmacy Care Coordinator acts as an extension of the ambulatory clinic team to support patient access to high touch, complex medication therapies. Works in collaboration with insurance companies, nursing, social workers, and pharmacy to obtain appropriate authorization for medications including registration with drug specific manufacturer programs when applicable. Performs tasks related to prescription billing including completing benefits investigations, assisting with the prior authorization process, and locating copay assistance options for patients to ensure affordability of specialty medications. The Pharmacy Care Coordinator escalates clinical support needs and questions to the pharmacist. Assists with clinic intervention outcomes tracking to monitor value of services. Coordinates patient outreach during clinic visits or via telephonic follow up to ensure continuity of care and optimize patient outcomes. Responsibilities may include working to establish and maintain short- and long-term quality improvement goals.

Job Description

Baptist Health is searching for a Specialty Pharmacy Care Coordinator to join our team at the Central Pharmacy, 1051 New Moody Ln, LaGrange, KY! Completes benefit investigations to verify patient eligibility for prescribed specialty medications. Maintains current knowledge of payer formularies and reimbursement. Engages in personal development to stay updated with pharmacy trends related to role and practice setting. Supports third party prior authorization process and obtain appropriate overrides to improve speed to therapy for new patients. Maintains accurate insurance information and monitor for prior authorization renewal needs to avoid gaps in medication therapy Triages patient or caregiver clinical questions, medication related concerns, and third-party insurance denials to the pharmacist for intervention as appropriate. Utilizes Electronic Health Record to maintain communication between departments and ensure accurate documentation of patient care activities. Communicates and represents pharmacy effectively throughout all levels of the organization. Serves as the primary point of contact with patients related to specialty medication needs and shows empathy and compassion to patients and caregivers. Serves as a liaison with physicians, nurse practitioners, physician assistants, pharmacists, nurses, and social workers to provide administrative support, communicate changes in medication related coverage and regulatory mandates. Facilitates enrollment of patients in patient assistance programs to maximize copay savings and assist with gathering appropriate documentation. Utilizes technology to organize daily outreach tasks to complete prescription refills, delivery coordination, and claim processing on time.

Minimum Qualifications

• High school diploma or equivalent.
• Registration with Kentucky Board of Pharmacy upon hire date.
• Pharmacy technician experience required.
• Prior experience with third party billing, financial counseling, or medical terminology and coding preferred.
• Prior experience with Epic electronic medical record preferred.

Baptist Health is an Equal Employment Opportunity employer. Founded in 1924 in Louisville, Kentucky, Baptist Health is a full-spectrum health system dedicated to improving the health of the communities it serves.

The Baptist Health family consists of 10 hospitals, employed and independent physicians, and more than 470 points of care, including outpatient facilities, physician practices and services, urgent care clinics, outpatient diagnostic and surgery centers, home care, fitness centers, and occupational medicine and physical therapy clinics.

Baptist Health’s eight owned hospitals include more than 2,300 licensed beds in Corbin, Elizabethtown, La Grange, Lexington, Louisville, Paducah, Richmond and New Albany, Indiana.

Baptist Health also operates two joint venture hospitals: the 410-bed Baptist Health Deaconess Madisonville in Madisonville, Kentucky with Deaconess Health System based in Evansville, Indiana, and the Baptist Health Rehabilitation Hospital, a 40-bed inpatient rehabilitation facility with Encompass Health, based in Birmingham, Alabama.

Baptist Health employs more than 24,000 people in Kentucky and surrounding states.

Baptist Health is the first health system in the U.S. to have all of its hospitals recognized by the American Nursing Credentialing Center with either a Magnet® or Pathway to Excellence® designation for nursing excellence.

Baptist Health’s employed provider network, Baptist Health Medical Group, has more than 1,820 employed providers offering care in 78 specialties, including approximately 862 physicians and 958 advanced practice clinicians.

Baptist Health’s physician network also includes more than 2,000 independent physicians.

Baptist Health is an Equal Employment Opportunity employer, and seeks to employ individuals without regard to race, color, national origin, gender, sexual orientation, gender identity, age, disability, marital status, citizenship status, military status, religious or political beliefs, protected veteran status, employment status or any other protected class identified in any federal, state, or local law.

Baptist Health specifically encourages minority, female, disabled, veteran and other candidates from diverse backgrounds to apply and strengthen our team.

Please note that Baptist Health is a drug-free workplace and employment with Baptist Health is subject to post offer, pre-employment drug testing.

Persons with hearing and speech impairments can contact Baptist Health facilities by using the Kentucky Relay Service, a toll-free telecommunication device for the deaf (TDD). For voice to TDD, call 800.648.6057. For TDD to voice, call 800.648.6056.