Central Infusion Prior Authorization Liaison

Adventist Health • Roseville, CA

1d

About The Position

Located in the metropolitan area of Sacramento, the Adventist Health corporate
headquarters have been based in Roseville, California, for more than 40 years.
In 2019, we unveiled our WELL-certified campus - a rejuvenating place for
associates systemwide to collaborate, innovate and connect.

Adventist Health Roseville and shared service teams have access to enjoy a
welcoming space designed to promote well-being and inspire your best work.

Job Summary:

Coordinates with the central financial clearance team to determine appropriate
infusion site of care for patients prescribed infusion and/or injection
therapies based on treatment type, patient appropriateness, and payer
qualifications using tools/data available. Assesses, develops, and recommends
the best method of providing ambulatory infusion pharmacy services to support
patients based on health system guidance. Ensures referrals flow through to home
infusion, alternate site and ambulatory pharmacies as applicable based on health
system guidelines.

Requirements

• Five years' as a pharmacy technician in areas such as Infusion or Specialty Pharmacy, including benefit verification, prior authorization, medical and pharmacy billing: Required
• State Pharmacy Technician license: Required (CA, OR, &/or HI): Required
• Pharmaceutical Technician Board certification: Required
• PTC OR CPhT: Required

Nice To Haves

• High School Education/GED or equivalent: Preferred
• Associate’s/Technical Degree or equivalent combination of education/related experience: Preferred
• Experience in Epic or similar electronic medical records (EMR) platforms: Preferred
• Knowledge of healthcare insurance, prior authorization and/or coding: Preferred
• Advanced certification (e.g., CHRI, CRCR, or 340B ACE): Preferred

Responsibilities

• Serves as the initial contact for all identified client site of care pharmacy prescriptions and referrals. Handles benefit reviews, prior authorization, product sourcing, EMR documentation, and denials management.
• Promotes the value and benefits of the pharmacy infusion hub and client infusion strategy. Facilitates patient referral in a timely manner and deliver exceptional client service to clinic staff and patients.
• Develops and maintains close relationships with clinic staff, physician, pharmacy and other hospital contacts. Acts as financial advocate for patient where needed; leverage charitable foundations, state programs, and/or manufacturer programs to ensure maximal patient access.
• Consults and implements process improvements to integrate services for better customer experience for physician, clinic staff, patient and pharmacy. Establishes and maintains strong relationships with client, demonstrating accountability for service delivery.
• Provides backup coverage to support clients and patients in the event of absence of other assigned resources. Works independently and collaboratively with client authorization resources, facilitates benefits verification and prior authorizations services for infusion site of care patients.
• Performs other job-related duties as assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED