Pharmacy Care Coordinator II

Baptist Healthcare System•Richmond, KY

4h•Onsite

About The Position

The Specialty Pharmacy Care Coordinator acts as an extension of the ambulatory clinic teams to support patient access to high touch, complex medication therapies. This position is based in a centralized specialty pharmacy call center setting under pharmacist supervision. The Specialty Pharmacy Care Coordinator functions in a multi-skilled environment which requires the application of teamwork, leadership and flexibility. Works in collaboration with insurance companies, nursing, and social workers to obtain appropriate authorization for medications including registration with drug specific manufacturer programs when applicable. Performs tasks related to prescription billing including completing benefits investigations, assisting with the prior authorization process, and locating copay assistance options for patients to ensure affordability of specialty medications. Assists with call center intervention outcomes tracking to monitor value of services. Coordinates telephonic patient outreach for new and enrolled patients to ensure continuity of care and optimize patient outcomes. Completes benefit investigations to verify patient eligibility for prescribed specialty medications. Maintains current knowledge of payer formularies and reimbursement. Engages in personal development to stay updated with pharmacy trends related to role and practice setting. Supports third party prior authorization process and obtain appropriate overrides to improve speed to therapy for new patients. Maintains accurate insurance information and monitor for prior authorization renewal needs to avoid gaps in medication therapy. Triages patient or caregiver clinical questions, medication related concerns, and third-party insurance denials to the pharmacist for intervention as appropriate. Utilizes Electronic Health Record to maintain communication between departments and ensure accurate documentation of patient care activities. Serves as the primary point of contact with patients related to specialty medication needs and shows empathy and compassion to patients and caregivers. Facilitates enrollment of patients in patient assistance programs to maximize copay savings and assist with gathering appropriate documentation. Utilizes technology to organize daily outreach tasks to complete prescription refills, delivery coordination, and claim processing on time. Demonstrates commitment to the quality, philosophy, and values of Baptist Health by maintaining compliance with established policies and procedures, organizational objectives, process improvement, and safety standards.

Requirements

High School or GED Required
National Pharmacy Technician Certification required
BLS required

Nice To Haves

1 year of experience preferred
Registration with Kentucky Board of Pharmacy upon hire date

Responsibilities

Acts as an extension of ambulatory clinic teams to support patient access to high touch, complex medication therapies.
Works in collaboration with insurance companies, nursing, and social workers to obtain appropriate authorization for medications, including registration with drug-specific manufacturer programs.
Performs tasks related to prescription billing, including completing benefits investigations, assisting with prior authorization, and locating copay assistance options.
Assists with call center intervention outcomes tracking.
Coordinates telephonic patient outreach for new and enrolled patients to ensure continuity of care and optimize patient outcomes.
Completes benefit investigations to verify patient eligibility for prescribed specialty medications.
Maintains current knowledge of payer formularies and reimbursement.
Engages in personal development to stay updated with pharmacy trends.
Supports the third-party prior authorization process and obtains appropriate overrides.
Maintains accurate insurance information and monitors for prior authorization renewal needs.
Triages patient or caregiver clinical questions, medication-related concerns, and third-party insurance denials to the pharmacist.
Utilizes Electronic Health Record to maintain communication and ensure accurate documentation.
Serves as the primary point of contact with patients related to specialty medication needs.
Facilitates enrollment of patients in patient assistance programs.
Utilizes technology to organize daily outreach tasks, including prescription refills, delivery coordination, and claim processing.
Demonstrates commitment to quality, philosophy, and values by maintaining compliance with policies, procedures, objectives, process improvement, and safety standards.