Lead Prior-Authorization Technician

GW Medical Faculty Associates•Arlington, VA

51d

About The Position

The GW Medical Faculty Associates (MFA) was incorporated in July 2000 as a not-for-profit, physician-led practice group. The organization functioned as an independent organization in support of The George Washington University School of Medicine and Sciences as a multi-specialty physician practice group. The GW MFA has grown to become the largest independent academic physician practice in the Washington, DC metro region with 375 physicians and 100 APP providers. In 2018, the MFA bylaws were revised to allow The George Washington University to serve as the sole corporate member while the MFA retained independent 501c3 status. The purpose of the change was to ensure alignment between the MFA and The George Washington University. MFA physicians provide comprehensive patient care, offering one practice for the whole person with 52 medical and surgical specialties. As members of the GW School of Medicine and Health Sciences faculty, MFA providers are teachers and mentors for medical students, residents, fellows, and researchers preserving the rich tradition of academics, research, and healing. In addition to maintaining a closely integrated alliance with The George Washington University and The George Washington University Hospital (GWUH) which is separately owned and operated by Universal Health Services (UHS), the GW MFA has active referring relationships with 12 area hospitals. The GW MFA's leading healthcare presence in the DC metro region is complemented by a network of community-based practices in DC, Maryland, and Virginia. Given its geographic location in central NW Washington, DC, and proximity to more than 175 resident embassies, the MFA continues to evolve its international clinical outreach. Position Summary To lead the development and coordination of the prior authorization team as they serve the GWMFA providers. Serve as a member of the Specialty Pharmacy team.

Requirements

High school diploma or an equivalent combination of training and experience.
Current and valid licensure as a Pharmacy Technician in the District of Columbia.
A minimum of 2 years of verified Pharmacy Technician experience in a retail, nursing home, medical center, or hospital pharmacy
Stand, walk, bend, twist, and reach for long periods of time in a clinical setting.
Must be able to occasionally lift or carry and push or pull up to 100 lbs. as part of the role
Regularly exposed to healthcare settings that may require personal protective equipment
Requires manual dexterity to operate a computer keyboard, calculator, copier machine, and other equipment.

Responsibilities

Maintain effective onboarding and training procedures for team members
Perform continuous quality improvement of prior authorization and pharmacy-initiated refill program
Manage time and attendance, payroll, and PTO requests for the team
Initiate prior authorizations for medications and work with providers on completion
Confirm patient demographics are accurate and insurance information is correct
Communicate with the clinical team and patients about prior authorization and refill status and provide updates accordingly
Identify patient foundation assistance and manufacturer copay assistance programs
Follow up with the pharmacy to ensure the medication is in process after approval was received
Process prior authorization renewals
Work with the provider to resolve prior authorization peer-to-peer reviews and denials
Transcription of new prescriptions to patient profile
Ensure correct third-party adjudication of specialty medications
Communicate with nurses and patients about prescription order status and provide updates accordingly
Communicate copays with patients before ordering medications
Make sure that specialty medications with existing PAR levels are appropriately stocked
Notify the patient when medication is available for pickup and/or schedule delivery
Basic familiarity with proper medication dosing, use, and required monitoring parameters for specialty medications
Perform refill reminders for patients on specialty medications and follow up with the prescriber if out of refills
File all completed prescriptions in accordance with department standards
At all times, maintain a courteous interaction with patients, visitors, departments, and medical personnel
Compliance with all established personnel and departmental policies
Preparation of prescriptions for pharmacist's review, following federal and local regulations (including labeling)
Refer issues that require professional judgment to a pharmacist for follow-up