Specialty Pharmacy Care Coordinator (Cardiology)

Baptist Health; Lexington (KY); On-site; USD 48,000 - 65,000; Full time

Job summary

Baptist Health is seeking a Specialty Pharmacy Care Coordinator to join our Cardiology team at Baptist Health Hamburg, Lexington, KY. This role supports patient access to high-touch, complex therapies and collaborates with insurance, nursing, and social workers to obtain appropriate authorizations.

Responsibilities include benefits investigations, prior authorization support, and patient outreach to ensure continuity of care and optimize outcomes in a specialty pharmacy clinic setting.

Qualifications

• High school diploma or equivalent.
• Registration with Kentucky Board of Pharmacy upon hire date.
• Pharmacy technician experience is preferred.
• PTCB certification preferred.

Responsibilities

• Completes benefit investigations for patient eligibility.
• Maintains knowledge of payer formularies and reimbursement.
• Supports prior authorization process to speed therapy.
• Maintains insurance information and monitors renewals to prevent gaps.
• Triage clinical questions to the pharmacist for intervention.

Skills

Empathy

Communication

Teamwork

Education

High school diploma

Pharmacy registration (KY)

Tools

Epic EMR

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.