Specialty Pharmacy Care Coordinator (Cardiology)

Kyeatright; Lexington (KY); Hybrid; USD 42,000 - 54,000; Full time

Job summary

Baptist Health Hamburg Cardiology in Lexington, KY seeks a Specialty Pharmacy Care Coordinator to support access to high-touch, complex therapies in a specialty pharmacy clinic setting under pharmacist supervision.

You will complete benefits investigations, assist with prior authorizations, and coordinate patient outreach while collaborating with insurance providers, nurses, social workers and physicians to optimize care and ensure timely therapy.

Qualifications

• High school diploma or equivalent is required.
• Pharmacy technician experience is preferred.
• PTCB certification is preferred.
• Experience with third-party billing or medical terminology and coding is preferred.
• Experience with Epic EMR is preferred.
• Must obtain 340B University or Apexus within 6 months.

Responsibilities

• Complete benefit investigations to verify patient eligibility for prescribed specialty medications.
• Maintain current knowledge of payer formularies and reimbursement.
• Support third-party prior authorization process and obtain appropriate overrides.
• Maintain accurate insurance information and monitor for renewal needs.
• Triage patient or caregiver questions to the pharmacist when appropriate.
• Use the EHR to communicate between departments and document patient care activities.
• Serve as the primary point of contact with patients regarding specialty medications.
• Coordinate enrollment in patient assistance programs to maximize copay savings.
• Organize daily outreach tasks for refills, delivery coordination and claim processing.

Skills

Pharmacy technician

Epic EMR

Insurance billing

Education

High school diploma or equivalent

Tools

Epic EMR

Billing software

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.### *If you would like to be part of a growing family focused on supporting clinical excellence, teamwork and innovation, we urge you to apply now!*