Specialty Pharmacy Care Navigator

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

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.