Specialty Pharmacy Care Coordinator Rheumatology

Baptist Healthcare System•Lexington, KY

10d•Onsite

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 to join our team at our Lexington Rheumatology Clinic at 330 Waller Avenue. Completes benefit investigations to verify patient eligibility for prescribed specialty medications. Assesses requirements for authorization of medications and maintain knowledge of payer formularies and reimbursement. Supports third party prior authorization process and obtain appropriate overrides for new patients. Maintains accurate insurance information and monitor for prior authorization renewal needs to avoid gaps in medication therapy. Identifies financial assistance options to maximize copay savings and increase therapy adherence. Serves as a liaison with physicians, nurse practitioners, physician assistants, pharmacists, nurses, and social workers to provide administrative support and communicate changes in medication-related coverage. Utilizes the Electronic Health Record (HER) to maintain communication between departments and ensure accurate documentation in patient electronic charts. Performs phone functions professionally and in a timely manner, including answering phones, returning calls, and checking voice mail. Coordinates patient scheduling for initial and follow-up appointments. Triages patient clinical questions and third-party insurance denials to the pharmacist for intervention as appropriate. Facilitates adherence to medications by coordinating face-to-face or telephonic patient outreach for timely refills. Maintains a record of activities to support data collection, analysis, and ongoing reporting to leadership related to patient metrics and financial performance. Acts as a contact person for all non-clinical patient/customer questions.

Requirements

High school diploma or equivalent.
Current or eligible for Kentucky pharmacy technician registration (if not already registered with KY Board of Pharmacy, registration requires only an application and fee).
2+ years pharmacy technician experience preferred.

Nice To Haves

National Pharmacy Technician Certification preferred.
Prior experience with third party billing, financial counseling, or medical terminology and coding preferred.
Prior experience with Epic EMR preferred.
Intermediate knowledge of computer systems and software, including Microsoft Excel and Microsoft Word preferred.
Demonstrated ability to collaborate with healthcare providers and patients to communicate effectively as a patient advocate preferred.

Responsibilities

Completes benefit investigations to verify patient eligibility for prescribed specialty medications.
Assesses requirements for authorization of medications and maintain knowledge of payer formularies and reimbursement.
Supports third party prior authorization process and obtain appropriate overrides for new patients.
Maintains accurate insurance information and monitor for prior authorization renewal needs to avoid gaps in medication therapy.
Identifies financial assistance options to maximize copay savings and increase therapy adherence.
Serves as a liaison with physicians, nurse practitioners, physician assistants, pharmacists, nurses, and social workers to provide administrative support and communicate changes in medication-related coverage.
Utilizes the Electronic Health Record (HER) to maintain communication between departments and ensure accurate documentation in patient electronic charts.
Performs phone functions professionally and in a timely manner, including answering phones, returning calls, and checking voice mail.
Coordinates patient scheduling for initial and follow-up appointments.
Triages patient clinical questions and third-party insurance denials to the pharmacist for intervention as appropriate.
Facilitates adherence to medications by coordinating face-to-face or telephonic patient outreach for timely refills.
Maintains a record of activities to support data collection, analysis, and ongoing reporting to leadership related to patient metrics and financial performance.
Acts as a contact person for all non-clinical patient/customer questions.