Specialty Pharmacy Patient Care Manager- KOP

Today, Jefferson Health and its network of hospitals and physician practices serve patients throughout the Delaware Valley. We have a robust network of 18 hospitals, 3500 physicians, 9600 nurses, 3,876 licensed beds, and physician practices throughout the counties of:

• Bucks
• Camden
• Gloucester
• Montgomery
• Philadelphia

We are Philadelphia's second largest employer, and nationally ranked by US News & World Report in seven specialties including #2 Ophthalmology (Wills Eye), #9 Rehabilitation (MossRehab), #10 in Orthopedics (Rothman Orthopaedics at Jefferson Health, Philadelphia Hand to Shoulder Center, 3B Orthopedics, the Abington Orthopedic & Spine). Whether you're in the city or the suburbs, Jefferson Health provides the exceptional care you expect - close to home or work - through our broad family of primary care physicians and specialists. Jefferson Health is home to nationally ranked experts who provide a personalized care plan for you. Sidney Kimmel Cancer Center - Jefferson Health is one of only 70 NCI-designated cancer centers in the country. With more than 30,000 employees, we are the largest health system in the Philadelphia region by total licensed beds. And our work to improve lives is never done.

In keeping with Jefferson's Mission, We Improve Lives, it is our goal to recruit, retain, develop and reward highly-qualified employees. If you are enthusiastic, caring and dedicated to service excellence, we invite you to consider joining Jefferson. Jefferson encourages its employees to expand their knowledge and develop their careers through growth opportunities and continuing education.

Responsibilities

Job Summary

Oversee the day-to-day operations of the Specialty Pharmacy involving intake, benefits investigation, prior authorization, payer appeals, fulfillment, patient out reaches and financial assistance in conjunction with the Specialty Pharmacy Manager where applicable to enhance consumer, referral source, and staff experiences. Evaluate current processes for efficiencies, productivity enhancements, and business growth. Work simultaneously on multiple special projects related to the business. Participate in QA and QI activities. Manage smooth operation of the department. Execute and assist with other responsibilities as assigned.

Essential Functions

• Interacts with co-workers, visitors, and other staff consistent with the values of Jefferson.

• Manage and lead the daily activities of the call center, front end client & provider services and fulfillment staff, including staffing models, workflow management and audit support functions

• Perform management functions that included, but is not limited to hiring, training and mentoring new staff members, ensuring staff competency, compliance with required trainings, and enforcing enterprise and departmental policies

• Establish and implement effective workplace procedures that are compliant within URAC and TJC accreditation standards

• Consult with supporting enterprise departments (Epic, Finance, Billing, Clinical/Quality, etc) to provide a better patient and provider experience and improve patient safety

• Communicate with internal and external vendors to optimize pharmacy services

• Develop, implement and maintain Process Improvement and Quality Improvement initiatives.

• Create and maintain a patient centric, quality assurance and accountability culture within the department in all work processes and outcomes

• Identify and implement opportunities that contribute to the overall growth of the Specialty Pharmacy business

Qualifications

Competencies (Knowledge, Skills, and Abilities Required):

Competency

Description

Long-term planning to create and lead initiatives that further the business' overall goals

Coordinating diverse teams to foster exchange of ideas and provide cross-team learning opportunities

Working across departments to find and implement solutions for potential problems and points of friction in order to maximize efficiency, revenue and client satisfaction

Ability to lead and manage in a changing environment

Ability to effectively interact with Patients, Prescribers, Referral Sources, Vendors, Pharmaceutical & other manufacturers, Specialty Pharmacy Companies, Third Party Payers, etc.

Minimum Education and Experience Requirements:

Education:

Bachelor's degree in sciences, education or other related field preferred

Experience:

3 to 5 years of experience in project management, client services, operations, administration - healthcare setting preferred

2 to 4 years of healthcare experience with increasing responsibilities (Specialty Pharmacy or pharmacy preferred).

Additional Information

• Excellent analytical and organizational skills

• Excellent knowledge of Microsoft Office products including Excel, Word, PowerPoint. Advanced knowledge is a strong plus

• Ability to communicate clearly and effectively, verbally and in writing, with referral sources, clients, payers, pharma, vendors, and staff

• Strong organizational skills, with ability to multitask, collate data from many sources and manage several tasks at any one time

• Self-Starter with excellent decision making, problem solving, and analytical skills

• Ability to adapt to the changing needs of the organization

Closing Statement

Jefferson includes Thomas Jefferson University and Jefferson Health, a dynamic university and health system with broad reach across the Delaware Valley. Jefferson is the second largest employer in Philadelphia and the largest health system in Philadelphia based on total licensed beds.

Through the merger of Thomas Jefferson University and Philadelphia University in 2017, our University includes ten colleges and four schools. We are an NCAA Division II university and an R2 national doctoral university offering undergraduate and graduate-level programs that provide students with a forward-thinking education in architecture, business, design, engineering, fashion and textiles, health, medicine and social science.

Jefferson Health, the clinical arm of Thomas Jefferson University, has grown from a three-hospital academic health center in 2015, to an 18-hospital health system through mergers and combinations that include hospitals at Abington Health, Aria Health, Kennedy Health, Magee Rehabilitation and Einstein Healthcare Network. We have over 50 outpatient and urgent care centers; ten Magnet-designated hospitals (recognized by the ANCC for nursing excellence); the NCI-designated Sidney Kimmel Cancer Center (one of only 70 in the country and one of only two in the region); and one of the largest faculty-based telehealth networks in the country. In 2021, Jefferson Health became the sole owner of HealthPartners Plan, a not-for-profit health maintenance organization in Southeastern Pennsylvania. We are the first health system regionally to create an aligned payer-provider partnership.

Jefferson's mission, vision and values create an organization that attracts the best and the brightest students, faculty, staff, and healthcare professionals, as well as the most visionary leaders to drive exceptional results.

• OUR MISSION: We improve lives.
• OUR VISION: Reimagining health, education and discovery to create unparalleled value
• OUR VALUES: Put People First, Be Bold & Think Differently and Do the Right Thing

As an employer, Jefferson maintains a commitment to provide equal access to employment. Jefferson values diversity and encourages applications from women, members of minority groups, LGBTQ individuals, disabled individuals, and veterans.

Par Reference Code

99222

---