Patient Care Advocate

Parkview Health Services•Rocky River, OH

3d•$22 - $28

About The Position

The patient care advocate serves as a crucial liaison for ensuring patients have timely access to necessary medications. This position is responsible for efficiently processing prior authorizations and appeals for both pharmacy and medical benefits, working closely with clinics and internal teams. This role requires a strong understanding of medication access processes, excellent communication skills, and a commitment to patient advocacy.

Requirements

Organizational skills sufficient to maintain consistently accurate records.
Ability to evaluate options and to make efficient decisions.
Current knowledge of all applicable state and federal pharmacy laws, rules, and regulations.
Computer skills that include proficiency with spreadsheets and use of the internet, as well as word processing, and efficient use of the internet and e-mail.

Responsibilities

Complete prior authorization requests on behalf of clinics, ensuring timely and accurate processing along with communicating determination with clinic point of contact.
Prepare and submit appeals for denied prior authorizations, ensuring all necessary documentation is included and deadlines are met.
Address client inquiries and concerns promptly and professionally, providing effective solutions.
Communicate effectively with clients, physicians, and other healthcare providers about medication statuses.
Develop and maintain a strong understanding of the medical information related to the specified medications to effectively complete authorization requests.
Proficiently utilize various electronic health records (EHR) systems, and other software platforms to access patient information and track progress.
Report any misconduct, suspicious or unethical activities to the Compliance Officer.
Represent the pharmacy in a professional and courteous manner in all interactions with patients and clinicians.
Ensure compliance with all licensure and federal, state, and local laws and regulations; observe the pharmacy’s policies on ‘’best practices’’.
Assist in resolving patient concerns and complaints.
Assume on-call responsibilities in accordance with pharmacy guidelines.
Report product incidents as required in accordance with pharmacy policy.
Participate in surveys conducted by authorized inspection agencies.
Participate in the pharmacy’s Performance Improvement program as requested by the Performance Improvement Coordinator.
Participate in pharmacy committees when requested.
Participate in in-service education programs provided by the pharmacy.
Pursue continuing education programs appropriate to job responsibilities and certification requirements.