Specialty Pharmacy Liaison

Beth Israel Lahey Health•Westwood, MA

4d•$29 - $39

About The Position

This position acts as a liaison between specialty and retail pharmacies and prescribers to document, submit, communicate outcomes for, and appeal pharmacy and medical prior authorizations as needed. The role is also involved in all aspects of obtaining patient access to prescribed medication. The liaison understands product and payer reimbursement landscapes and prior authorization guidelines and processes; gathers and reviews data needed for pharmacy and medical prior authorization approvals; resolves insurance-related issues; and assists patients with financial assistance options. The position provides customer service to internal and external customers, maintains frequent phone contact with patients, providers, and pharmacy staff, clarifies prescription orders as appropriate, and serves as a direct contact for pharmacy benefit, clinical, and program information. The role coordinates services with providers, specialty pharmacies, and national account managers to improve patient turnaround time. It also communicates with patients about their medications and coordinates teaching visits. The liaison manages multiple initiatives, independently resolves complex accounts, networks with key contacts, and provides training and support to inter-departmental associates.

Requirements

High school diploma or GED.
1–3 years of related work experience in prior authorization.
Experience with computer systems, including web-based applications and some Microsoft Office applications such as Outlook, Word, Excel, PowerPoint, or Access.

Nice To Haves

Massachusetts Registered Pharmacy Technician license or Pharmacy Technician Certification Board registration preferred.
PTCB certification.
Specialty pharmacy experience and/or prior authorization experience.
Knowledge of medication use in RA, GI, transplant, hepatitis C, infectious disease (including HIV), and/or oncology.

Responsibilities

Understand product and payer reimbursement landscapes, prior authorization guidelines, and processes.
Collect and review data required for pharmacy and medical prior authorization approvals.
Resolve insurance-related issues, including prior authorizations, and assist patients with financial assistance.
Provide customer service to internal and external customers, address requests promptly and accurately, escalate complaints appropriately, and maintain frequent phone contact with patients, providers, and pharmacy staff.
Clarify prescription orders with a pharmacist and/or clinician as appropriate.
Serve as the direct patient and provider contact for pharmacy benefit, clinical, and program information.
Coordinate services with providers, specialty pharmacies, and national account managers to improve patient turnaround time.
Communicate with patients to increase awareness of their medications and coordinate teaching visits.
Manage multiple strategic initiatives, reprioritize work when needed, resolve complex accounts independently, and determine methods for new or special assignments with minimal supervision.
Network with key contacts inside and outside the area of expertise.
Provide training and support to inter-departmental associates.