Specialty Pharmacy Care Navigator

Memorial Hermann Health System; United States; On-site; USD 38,000 - 54,000; Full time

Job summary

Memorial Hermann Health System is seeking a Pharmacy Technician to support the Specialty Pharmacy Program. The role involves entering and processing prescriptions, handling claims adjudication, and coordinating with insurance plans, physicians, and patients to navigate prior authorizations and financial assistance.

You will work with the Director of Specialty Pharmacy, maintain accurate records, provide patient education, and ensure HIPAA compliance while delivering compassionate, efficient

Qualifications

• Education: High school diploma or GED.
• Licenses/Certifications: Licensed as a registered Pharmacy Technician or Pharmacist Intern in the State of Texas.
• Five (5) years experience in specialty, retail, mail order, or hospital pharmacy
• Demonstrated attention to detail in completing tasks
• Ability to efficiently complete multiple daily work assignments while operating independently
• Knowledge of medical and pharmaceutical terminology
• Demonstrated experience in customer service
• Strong interpersonal and communication skills
• Experience in specialty pharmacy or pharmacy benefit management preferred

Responsibilities

• Enters and processes claims accurately, for new/refill prescriptions including resolving rejected claims.
• Works seamlessly in the pharmacy and/or alongside the medical office staff to serve patients both face-to-face and over the phone as needed.
• Reviews all pertinent medical documentation from physician offices and other healthcare facilities.
• Clarifies prescription orders with pharmacist and/or clinician as appropriate.
• Assists to resolve insurance related issues, including prior authorizations (PAs), and assists patients with various forms of financial assistance.
• Assists pharmacist in with the retrieval of prescription files, patient files, and other such records pertaining to the practice of pharmacy.
• Answers, resolves, and triages inbound inquiries on the telephone.
• Performs pharmaceutical calculations.
• Communicates directly with patients to assist them with medication awareness.
• Reports errors, omissions or incidents to pharmacist.
• Maintains productivity rates and meet quality expectations determined by management.
• Communicates with various pharmacy team members as needed to coordinate timely prescription dispensing.
• Participates in staff meetings and helps with special projects.
• Complies with all regulatory requirements, including HIPAA/HITECH.
• Ensures safe care to patients, staff and visitors; adheres to all Memorial Hermann policies, procedures, and standards within budgetary specifications including time management, supply management, productivity and quality of service.
• Promotes individual professional growth and development by meeting requirements for mandatory/continuing education and skills competency; supports department-based goals which contribute to the success of the organization; serves as preceptor, mentor and resource to less experienced staff.
• Demonstrates commitment to caring for every member of our community by creating compassionate and personalized experiences.
• Models Memorial Hermann’s service standards by providing safe, caring, personalized and efficient experiences to patients and colleagues.
• Other duties as assigned.
• Together, we’re creating an environment where exceptional care can flourish. It starts with you.

Skills

Attention to detail

Customer service

Communication skills

Pharmacy terminology

Prior authorization

Education

High School Diploma or GED

Tools

Microsoft Office

Pharmacy Software

Job description

Memorial Hermann Health System is seeking a Pharmacy Technician to support the Specialty Pharmacy Program. The role involves entering and processing prescriptions, handling claims adjudication, and coordinating with insurance plans, physicians, and patients to navigate prior authorizations and financial assistance.

You will work with the Director of Specialty Pharmacy, maintain accurate records, provide patient education, and ensure HIPAA compliance while delivering compassionate, efficient