Current jobs related to Specialty Pharmacy Financial Access Coordinator, Lead; Mount Sinai Hospital; Full Time; Hybrid - New York, New York - Mount Sinai Health System
-
New York, New York, United States Mount Sinai Health System Full timeDescriptionUnder direct supervision of the Director of Specialty Pharmacy, the Specialty Pharmacy Manager and the Specialty Pharmacy Clinical Liaison, the Specialty Pharmacy Access Coordinator Lead supervises Financial Access Coordinator staff and interacts with clinical employees on multiple levels, including pharmacists, nurses, medical/clinical staff,...
-
New York, New York, United States Mount Sinai Morningside Full timeDescriptionJob DescriptionPosition TitleProject Coordinator, Labor Relations-Mount Sinai Hospital-Full Time-DaysPosition SummaryThe Project Coordinator, Labor Relations oversees the development and ensures the execution of complex projects concerning the Labor Relations and/or Human Resources Departments. The Coordinator follows projects through all phases,...
-
New York, New York, United States Mount Sinai Health System Full timeDescriptionThe Pharmacy Manager oversees the day to day operations of the various pharmacy areas pursuant to the distribution, administration and drug information of medication provided throughout the hospital. This individual ensures the utilization ofmedication safety principles to assure positive therapeutic outcomes.Responsibilities1. Provides direction...
-
New York, New York, United States Mount Sinai Morningside Full timeDescriptionJob DescriptionThe Transplant Coordinator is a Registered Professional Nurse, Nurse Practitioner or Physician Assistant with specific knowledge and skills who participates in the coordination of clinical programs and services for designated patient populations within the Transplantation Institute.ResponsibilitiesResponsible ForDevelopment,...
-
New York, New York, United States Mount Sinai Health System Full timeDescriptionPrepares medication orders for review by a pharmacist. Maintains an accurate, current census, including cassette bin labels, for all assigned areasResponsibilitiesPrepackages and labels medications, fills unit dose cassettes and assists in the maintenance of records associated with these functionsAudits the records of controlled substances,...
-
New York, New York, United States Mount Sinai Health System Full timeDescriptionResponsible for carrying out clinical pharmacy services, promoting clinically and evidence-based rational drug therapy, and sound pharmaceutical care through the development of new (or expansion of existing) pharmacy practice programs, drug therapy policies, and other programs. Serves as a clinical pharmacy resource for the health system and its...
-
New York, New York, United States Mount Sinai Morningside Full timeDescriptionJob DescriptionThe Administrative Manager oversees the administrative, operational and financial activities of a department or medical care unit, typically with oversight of 1-2 areas. Ensures the successful coordination and delivery of the day-to-day operations including staffing and administration of policies and...
-
New York, New York, United States Mount Sinai Health System Full timeDescriptionThe Senior Buyer negotiates contractual arrangements between Mount Sinai Medical Center and selected vendors committing funds to ensure the procurement of high quality equipment, supplies and other products at optimum cost. Prepares and evaluates bids; awards contracts for large dollar relationships and purchases. Develops RFO's for specialized...
-
Registrar-Radiology Associates
2 weeks ago
New York, New York, United States Mount Sinai Morningside Full timeDescriptionJob DescriptionThe Registrar is responsible for the business aspect of the department as well as the patient focused care delivery within the department. Activities include: registration, insurance verification and notification, updating of financial and demographic information, reception and other duties as assigned.ResponsibilitiesGreet and...
-
Certified Pharmacy Technician; Full Time; Variable
11 hours ago
New York, New York, United States Mount Sinai Morningside Full timeDescriptionJob DescriptionThe Certified Pharmacy Technician prepares, under Mount Sinai Pharmacy guidelines, pharmaceutical orders for patient care areas, maintains adequate stock levels, reviews medical areas for expired drugs, maintains refrigeration temperature logs, and provides general assistance to pharmacists.ResponsibilitiesFills medication orders...
Specialty Pharmacy Financial Access Coordinator, Lead; Mount Sinai Hospital; Full Time; Hybrid
2 weeks ago
Under direct supervision of the Director of Specialty Pharmacy, the Specialty Pharmacy Manager and the Specialty Pharmacy Clinical Liaison, the Specialty Pharmacy Access Coordinator Lead supervises Financial Access Coordinator staff and interacts with clinical employees on multiple levels, including pharmacists, nurses, medical/clinical staff, Finance personnel, department managers, access services staff, and Billing Assistants. External contacts may include third party payers, accrediting bodies, insurance /PBM companies, government peer review organizations, accrediting bodies,external partners, and referring physicians. The relationships are inherent to the success of this position. The Lead is primarily responsible for, but not limited to, oversight of staff responsible for the prompt attention to prior authorization of specialty medications, oversight of the quality of work done in key department systems, support of medical staff, assistance in obtaining financial support for patients, and timely communication with medical providers, including mail correspondence, messaging, telephone correspondence and EHR documentation.
Responsibilities1.Organizes the duties of subordinate technical and clerical personnel, including less experienced Specialty Financial Pharmacy Access Coordinators, and billers.
2.Maintains thorough documentation on all authorization requests, prescription verifications and other data by facility.
3.Supports supervising Pharmacists.
4.Supports manages and directors in the training and mentoring of new pharmacy personnel; nurtures a teamwork environment.
5.Periodically meets with and manages vendors and pharmaceutical manufacturers.
6.Supports, facilitates, and reviews departmental projects, initiatives, and partner programs
7.Works with department pharmacists and administrators to design, administer, and support quality assurance and related tasks
8.Accesses and reviews work in all key department systems (dispense, clinical management, EMR)
9.Organizes and presents reports and analytics as requested.
10.Reviews and evaluates outpatient take-home prescriptions and determines feasibility of processing through patient and payer-preferred specialty pharmacy and, if not, coordinates service with the correct pharmacy group.
11.Obtains prior authorizations from intermediaries and payers, including managed care companies, insurance companies or others as appropriate. Ensures completion of activities that maximize revenue capture for high-cost medications.
12.Facilitates a high level of customer service by the completion of applications, including those for the Patient Assistance Program (PAP) and co-pay assistance.
13.Interacts with medical and professional staff on a case by case basis to obtain appropriate clinical documentation to ensure accurate indications in the patient's medical record before completion of third party authorization. This may include contacting referring physicians for information.
14.Communicates with appropriate individuals (i.e., patient, providers, and pharmacy staff) regarding outcomes of prior authorizations and responds to complex questions from third party payers and clinical staff regarding medication-related issues and reimbursement.
15.Adjudicates approved prescriptions through the pharmacy software system or begins the appeal process for denied prescriptions.
16.Processes PAP (Patient Assistance Program) requests. Documents actions taken, runs weekly reports, keeps open lines of communication by facilitating between pharmacy, other healthcare professions, the patient, medication manufacturers and third party payers.
17.Runs Pharmacy benefit checks at the providers' requests; periodically performs software tests for proper functionality to ensure coverage for specific medications.
18.Maintains compliance with all pertinent regulations and laws (HIPAA, Board of Pharmacy, etc).
19.Other duties as assigned.
Education Requirements Associates degree preferred
Qualifications3+ years of retail pharmacy technician experience or related health care administrative, and a strong familiarity with the prior authorization process preferred. Working knowledge of third party payer plans and how they are processed, of medication reimbursement, including the prior authorization process, proficiency in the procurement of financial assistance for patients with government-sponsored health plans including Medicare , Medicaid and TriCare.
Preferred:
3 years of health care related billing and benefits investigation
1 year of retail pharmacy experience
1 year of PBM payer operations
1 year of hospital/institutional pharmacy
Non-Bargaining Unit, B Offsite Pharmacy OPS - MSH, Mount Sinai Hospital
