Specialty Pharmacy Liaison

Beth Israel Lahey Health•Westwood, MA

2d•$29 - $39

About The Position

This position acts as a liaison between specialty and retail pharmacies and prescribers to document, submit, communicate outcomes, and appeal pharmacy and medical prior authorizations. The role also supports all aspects of obtaining patient access to prescribed medication. The Specialty Pharmacy Liaison understands product and payer reimbursement landscapes and prior authorization guidelines and processes; gathers and reviews information needed for pharmacy and medical prior authorizations; resolves insurance-related issues; and assists patients with financial assistance options. The position provides customer service to internal and external customers, maintains frequent contact with patients, providers, and pharmacy staff, clarifies prescription orders with pharmacists or clinicians as appropriate, and serves as a direct patient and provider contact for pharmacy benefit, clinical, and program information. The role coordinates with providers, specialty pharmacies, and national account managers to improve patient turnaround time; helps patients understand their medications and coordinates teaching visits; manages multiple initiatives and complex accounts with minimal supervision; networks with internal and external contacts; and provides training and support to colleagues in other departments.

Requirements

High school diploma or GED.
Massachusetts Registered Pharmacy Technician license.
3–5 years of related work experience in pharmacy.
Experience with computer systems, including web-based applications and some Microsoft Office applications such as Outlook, Word, Excel, PowerPoint, or Access.
Ability to communicate clearly and effectively in written English with internal and external customers.
Ability to comprehend and communicate complex verbal information in English to medical center staff, patients, families, and external customers.
Working knowledge of standard concepts, practices, procedures, and policies, and the ability to apply them in varied situations.
Ability to provide professional, respectful, service-oriented customer support and remain calm in stressful situations.

Nice To Haves

PTCB certification.
Specialty pharmacy experience and/or prior authorization experience.
Knowledge of medication use in rheumatoid arthritis, gastrointestinal conditions, transplant, hepatitis C, infectious disease (including HIV), and/or oncology.

Responsibilities

Understand product and payer reimbursement landscapes, prior authorization guidelines, and related processes.
Collect and review data needed for pharmacy and/or medical prior authorization approvals.
Resolve insurance-related issues, including prior authorizations, and assist patients with financial assistance forms and resources.
Provide customer service to internal and external customers, respond to requests promptly and accurately, escalate complaints when appropriate, and maintain frequent phone contact with patients, providers, and pharmacy staff.
Clarify prescription orders with pharmacists and/or clinicians 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 promote medication awareness and coordinate teaching visits.
Manage multiple strategic initiatives, reprioritize work as needed, resolve complex accounts independently, and determine methods and procedures 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.