Specialty Pharmacy Care Coord
4 weeks ago
Job Summary
The Specialty Pharmacy Care Coordinator acts as an extension of the ambulatory clinic team to support patient access to high touch, complex medication therapies. Works in collaboration with insurance companies, nursing, social workers, and pharmacy to obtain appropriate authorization for medications including registration with drug specific manufacturer programs when applicable. Performs tasks related to prescription billing including completing benefits investigations, assisting with the prior authorization process, and locating copay assistance options for patients to ensure affordability of specialty medications.
Baptist Health is recruiting a Specialty Pharmacy Care Coordinator to join our team at the Central Pharmacy, LaGrange, KY.
The Specialty Pharmacy Care Coordinator acts as an extension of the ambulatory clinic team to support patient access to high touch, complex medication therapies.
Duties and Responsibilities:
- Complete benefit investigations to verify patient eligibility for prescribed specialty medications.
- Assess requirements for authorization of medications most commonly prescribed and maintain current knowledge of payer formularies and reimbursement.
- Support third party prior authorization process and obtain appropriate overrides to improve speed to therapy.
- Maintain accurate insurance information and monitor for prior authorization renewal needs to avoid gaps in medication therapy.
- Identify financial assistance options to maximize copay savings and increase therapy adherence.
- Serve as a liaison with physicians, nurse practitioners, physician assistants, pharmacists, nurses, and social workers to provide support.
- Utilize EMR to maintain communication between departments and ensure accurate documentation in patient electronic charts.
- Support pharmacist with in-clinic or telephonic patient activities.
- Facilitate adherence to medications by coordinating face to face or telephonic patient outreach to ensure timely refills.
- Coordinate patient scheduling for initial and follow up appointments.
- Triage patient clinical questions and third-party insurance denials to the pharmacist for intervention as appropriate.
Qualifications:
- High school diploma or equivalent
- Current or eligible for Kentucky pharmacy technician registration (if not already registered with KY Board of Pharmacy, registration requires only an application and fee).
- National Pharmacy Technician Certification preferred, not required to apply.
- 2+ years pharmacy technician experience preferred. not required to apply.
- Prior experience with third party billing, financial counseling, or medical terminology and coding preferred
- Prior experience with Epic EMR preferred
- Completion of 340B University or Apexus certification within 6 months of hire
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