Specialty Pharmacy Care Coordinator - Cardiology

Baptist Health; Elizabethtown (KY); On-site; USD 42,000 - 55,000; Full time

Job summary

Baptist Health Hardin in Elizabethtown, KY is seeking a Specialty Pharmacy Care Coordinator to support access to high-touch, complex medication therapies within the Cardiology team.

You will complete benefits investigations, assist with prior authorizations, enroll patients in assistance programs, coordinate with insurers, clinicians, and social workers, and document care activities in the electronic health record.

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.

Responsibilities

• 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.

Skills

Pharmacy technician experience

Prior authorization processes

Billing and reimbursement knowledge

Medical terminology

Interdepartmental collaboration

Education

High school diploma or equivalent

Registration with Kentucky Board of Pharmacy

Tools

Epic EMR

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 Cardiology team at Baptist Health Hardin, Elizabethtown, 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.