Specialty Pharmacy Care Coordinator (Cardiology)

Baptist Health System, Inc.; Lexington (KY); On-site; USD 48,000 - 62,000; Full time

Job summary

Baptist Health Hamburg, Lexington, KY, is seeking a Specialty Pharmacy Care Coordinator to join our Cardiology team in a specialty pharmacy clinic setting under pharmacist supervision.

You will complete benefit investigations, manage prior authorizations, maintain payer knowledge, and coordinate with physicians and social workers to support patients’ medication access and continuity of care.

Qualifications

• High school diploma or equivalent is required.
• Registration with Kentucky Board of Pharmacy upon hire date.
• Pharmacy technician experience is preferred.
• Pharmacy Technician National Certification (PTCB) is preferred.
• Prior experience with third party billing, financial counseling, or medical terminology and coding preferred.
• Prior experience with Epic electronic medical record preferred.
• Must obtain 340B University or Apexus within 6 months.

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.
• Supports third party prior authorization process and obtains appropriate overrides.
• Maintains insurance information and monitors prior authorization renewal needs.
• Triages clinical questions to the pharmacist for intervention as appropriate.
• Uses EHR to document patient care activities and maintain communication.
• Represents pharmacy throughout the organization.
• Acts as primary contact with patients for specialty medication needs with empathy.
• Coordinates with physicians, nurses, and social workers for coverage changes.
• Facilitates enrollment in patient assistance programs to maximize copay savings.
• Organizes daily outreach tasks for refills, delivery coordination, and claim processing.

Skills

Benefit investigations

Prior authorization

EHR navigation

Patient outreach

Pharmacy terminology

Education

High school diploma

Kentucky Board of Pharmacy registration

PTCB certification (preferred)

Job description

Summary

The Specialty Pharmacy Care Coordinator acts as an extension of the ambulatory clinic teams to support patient access to high touch, complex medication therapies. This position is based in a specialty pharmacy
clinic setting under pharmacist supervision. The Specialty Pharmacy Care Coordinator functions in a multi-skilled environment which requires the application of teamwork, leadership and flexibility. Works in collaboration with insurance companies, nursing, and social workers 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. Assists with clinic intervention outcomes tracking to monitor value of services. Coordinates patient outreach for new and enrolled patients to ensure continuity of care and optimize patient outcomes.

Job Description:

_ Baptist Health is searching for a Specialty Pharmacy Care Coordinator to join our Cardiology team at Baptist Health Hamburg, Lexington, 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 is preferred.
• Pharmacy Technician National Certification (PTCB) is preferred.
• Prior experience with third party billing, financial counseling, or medical terminology and coding preferred.
• Prior experience with Epic electronic medical record preferred.
• Must obtain 340B University or Apexus within 6 months.

Baptist Health is an Equal Employment Opportunity employer.