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Central Patient Engagement Specialist

4 months ago

Columbus, United States AndHealth Full time
Job DescriptionJob Description

Central Patient Engagement Specialist
Full Time
Columbus, OH

AndHealth is a healthcare technology company created to help people reverse chronic disease. We are driven by the goal of making world-class specialty care accessible and affordable to all. We partner with health systems, community health centers, plans, and employers to remove barriers to care to ensure all people have access to the care they deserve.

We are looking for a Central Patient Engagement Specialist to play an essential role at AndHealth. This position is located at our corporate office in Columbus, OH. We will consider remote options on a case by case basis.

Key Deliverables:

  • Ensure superior medication access for patients living with chronic health conditions.
  • Ensure time to therapy is as short as possible by reducing barriers to specialty medication access (PA, cost, insurance).
  • Proactively check on every medication fill (first fill, refill) to ensure we can solve any access barriers ahead of the next fill. 
  • When there is an access challenge, take ownership of the solution and track it until the patient fills the Rx.
  • Partner with Patient Navigators, Coaches, Pharmacists, and Providers (all patient facing teams) to ensure you reach and communicate with the patient in their most preferred way. 
  • Identify and enroll patients into the appropriate copay cards, patient assistance programs, or other mechanisms to decrease the cost burden and improve operational efficiencies.
  • Carefully follow SOP when documenting patient receipt of fill and access challenges.
  • Routinely communicate with patients to ensure improved health outcomes by reducing barriers and improving adherence.  Understand and learn their preferred method of communication (app, text, phone, email, through other Care Team members) and leverage that communication channel. 
What you’ll do in the role:
  • Proactively engage with patients living with chronic health conditions to complete benefits verification and assist with identifying appropriate secondary coverage.
  • Assist patients with benefits enrollment questions.
  • Complete medical and pharmacy insurance verification and coverage determinations for medications, imaging, and procedures. 
  • Proactively notify Providers of formulary restrictions and work with them when a medication needs to be adjusted.
  • Own completing, submitting, documenting, and tracking prior authorizations and appeals.
  • Understand what clinical criteria are required by medications and insurances to ensure the patient can get the most accurate determination from the plan. 
  • Use phone calls and medically urgent channels when needed when medication is time sensitive. 
  • Track approval period and renew PAs ahead of expiration to mitigate gaps in therapy. 
  • Regularly contact or communicate with patients regarding current medication utilizations and ongoing needs, as well as with pharmacies.
  • Consult with pharmacists or providers regarding all clinical needs of patients, routing all clinical interventions or counseling to an appropriate licensed clinician.
  • Assist patients with scheduling prescriptions, payment, fills, or deliveries at various pharmacy locations.
  • Generate reports routinely to identify new patients, upcoming medication needs, and adherence-related data.
  • Patient adherence monitoring, including filling verification with patients and pharmacies.
  • Other responsibilities as needed.
Education & Licensure Requirements:
  • Bachelor’s degree is preferred.
  • Certified Pharmacy Technician (PTCB or ExCPT) is preferred.
  • Must be willing to obtain and maintain licenses or certifications in multiple states if applicable.
Other Skills or Qualifications:
  • 3+ years of pharmacy or nurse navigation experience is preferred.
  • Excellent written and oral communication skills.
  • Strong attention to detail and ability to handle multiple things simultaneously.
  • Comfortable with technology and ability to adapt to new systems.
  • The position will be based in Columbus.  If not, the person will be expected to travel regularly to AndHealth office to work with their team.  
  • Must be organized and able to work independently.
  • COVID-19 vaccination is required.
Here’s what we’d like to offer you:
  • Equal investment and support for our people and patients.
  • A fun and ambitious start-up environment with a culture that takes on big things, takes risks, and learns quickly.
  • The ability to demonstrate creativity, innovation, and conscientiousness, and find joy in working together.
  • A team of highly skilled, incredibly kind, and welcoming employees, every one of whom has something unique to offer.
  • We know that the overall success of our business is a collaborative effort, and we strive to provide ongoing opportunities for our employees to learn and grow, both personally and professionally.
  • Full-time employees are eligible to participate in our benefits package which includes Medical, Dental, Vision Insurance, Company, and Paid time off, Short- and Long-Term Disability, and more.
We are an equal opportunity and affirmative action employer. We embrace diversity and are committed to creating an inclusive environment for all employees. Applicants will be considered for employment without regard to race, religion, gender, gender identity, sexual orientation, national origin, age, disability, or veteran status.

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