Specialty Pharmacy Care Navigator

Riverside Health; Chesapeake (VA); On-site; USD 68,483,251 - 89,114,188; Full time

Job summary

Riverside Health System in Chesapeake, Virginia is seeking a Specialty Medication Coordinator to manage third-party billing, prior authorizations, and patient financial assistance for high-dollar specialty medications (oncology, infectious disease, MS).

This role coordinates with insurance carriers and foundations, maintains accurate documentation, and ensures HIPAA-compliant handling of patient information while supporting care coordination and accurate medication processing.

Qualifications

• 3-4 years as Pharmacy Technician, LPN or CMA (Required).
• Experience obtaining and managing medication prior authorizations (Preferred).
• Experience with patient assistance programs (Preferred).

Responsibilities

• Process referrals and submit documentation to insurers or foundations to expedite prior authorizations and patient assistance.
• Work with other departments to obtain prior authorizations and patient assistance medications.
• Document intake referrals and prior authorization information accurately in the patient record.
• Track patient refills and coordinate timely infusion or prescription services.
• Support HIPAA compliance in handling patient data.
• Assist management with inspections, audits, reports, and training to ensure standards are met.

Skills

Medical terminology

Pharmacy software knowledge

Customer service

Documentation and data entry

HIPAA compliance

Education

Pharmacy Technician Training

Licensed Practical Nurse

Certified Medical Assistant

Advanced specialty pharmacy certification

Tools

EHR systems

Job description

Riverside Health System in Chesapeake, Virginia is seeking a Specialty Medication Coordinator to manage third-party billing, prior authorizations, and patient financial assistance for high-dollar specialty medications (oncology, infectious disease, MS).

This role coordinates with insurance carriers and foundations, maintains accurate documentation, and ensures HIPAA-compliant handling of patient information while supporting care coordination and accurate medication processing.