Specialty Pharmacy Navigator - Hybrid Role, Patient Access

Cencora, Inc.; Chicago (IL); Hybrid; USD 74,000 - 147,000; Full time

Job summary

Cencora seeks a pharmacist to coordinate ambulatory pharmacy partnerships in the greater Chicago area. The role involves engaging specialty practices, processing prescriptions, and maximizing patient access through insurance adjudication and prior authorizations.

Hybrid work across Chicago, Hinsdale and Westchester areas is offered, with some remote work. A PharmD and active license are preferred, plus 5+ years in relevant pharmacy settings and experience with specialty drugs.

Qualifications

• PharmD degree strongly preferred.
• Active pharmacist license in the appropriate state of practice.
• 5+ years community/retail/ambulatory pharmacy or health-system related experience.
• Experience in specialty pharmacy and/or processing prior authorizations is highly desirable.

Responsibilities

• Access physician practices for potential specialty Rx value using tools/data available.
• Establish communication with targeted specialty practices, arranging meetings with key stakeholders/decision makers.
• Demonstrate value of ambulatory pharmacy partnership to specialty practices.
• Ensure prescriptions flow through to ambulatory pharmacy and are identified by pharmacy staff.
• Establish patient profiles, including third-party payor(s) and clinical information.
• Process prescriptions, including insurance adjudication and product sourcing.
• Prepare and submit prior authorization paperwork; manage denials.
• Triage prescriptions which are limited distribution drugs or out-of-network.
• Act as financial advocate for patient where needed; leverage charitable foundations, state programs, and/or manufacturer programs to ensure maximal patient access.
• Coordinate pickup/courier delivery of Rx's with patient.
• Maintain auditable records showing proof-of-delivery.
• Follow up with patient to ensure refills are ordered on time and address and ADR's or clinical questions.
• Inform physician office of patient through process; document in EMR as necessary.
• Maintain relationships with physician offices through periodic visits/meetings.
• Assist with program financial reporting to client/data collection.
• Cross-train to ambulatory pharmacy; assist with staffing needs as required.

Skills

Microsoft Office

Pharmacy dispensing systems

Insurance adjudication processes

Clinical data interpretation

Education

PharmD degree

Active pharmacist license

Tools

Dispensing software

EMR systems

Job description

Cencora seeks a pharmacist to coordinate ambulatory pharmacy partnerships in the greater Chicago area. The role involves engaging specialty practices, processing prescriptions, and maximizing patient access through insurance adjudication and prior authorizations.

Hybrid work across Chicago, Hinsdale and Westchester areas is offered, with some remote work. A PharmD and active license are preferred, plus 5+ years in relevant pharmacy settings and experience with specialty drugs.