Specialty Pharmacy Care Coordinator II (Neurology)

BHSNicholasville, KY
2dOnsite

About The Position

Summary 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 specialty pharmacy clinic setting under pharmacist supervision. The Specialty Pharmacy Care Coordinator functions in a multiskilled 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 clinic intervention outcomes tracking to monitor value of services. Coordinates patient outreach for new and enrolled patients to ensure continuity of care and optimize patient outcomes. Job Description: Baptist Health is looking for a Specialty Pharmacy Care Coordinator II to join our Neurology team at 610 East Brannon Rd, Nicholasville, KY! 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. Communicates and represents pharmacy effectively throughout all levels of the organization. Serves as the primary point of contact with patients related to specialty medication needs and shows empathy and compassion to patients and caregivers. Serves as a liaison with physicians, nurse practitioners, physician assistants, pharmacists, nurses, and social workers to provide administrative support, communicate changes in medication related coverage and regulatory mandates. 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 diploma or equivalent.
  • Pharmacy technician experience required.
  • Registration with Kentucky Board of Pharmacy upon hire date.
  • National Pharmacy Technician Certification required.

Nice To Haves

  • Prior experience with third party billing, financial counseling, or medical terminology and coding preferred.
  • Prior experience with Epic electronic medical records preferred.

Responsibilities

  • 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.
  • Communicates and represents pharmacy effectively throughout all levels of the organization.
  • Serves as the primary point of contact with patients related to specialty medication needs and shows empathy and compassion to patients and caregivers.
  • Serves as a liaison with physicians, nurse practitioners, physician assistants, pharmacists, nurses, and social workers to provide administrative support, communicate changes in medication related coverage and regulatory mandates.
  • 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

Benefits

  • Tuition Assistance reimbursement program
  • 40 hours of Paid Time Off available for use upon hire
  • Company paid Maternity and Paternity Leave
  • Bereavement Leave (includes pets)
  • Employee Assistance Program
  • Retirement plans with company match
  • Company paid Basic Life Insurance & Long-Term Disability
  • Health Insurance, Pharmacy, Dental, Vision and much more!

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What This Job Offers

Job Type

Full-time

Career Level

Mid Level

Education Level

High school or GED

Number of Employees

5,001-10,000 employees

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