Specialty Pharmacy Patient Advocate
About The Position
Banner Health is seeking a Specialty Pharmacy Patient Advocate for its Scottsdale Health Center location. In this role, you will be responsible for completing prior authorizations, communicating outcomes to providers and patients, and assisting patients in obtaining financial assistance for specialty medications through copay cards, grants, and free drug applications. You will collaborate with providers and third parties to mitigate the cost challenges associated with specialty medications. This is a full-time position with standard business hours (Monday-Friday, 8 AM - 5 PM). Banner Pharmacy Services is a leader in innovative pharmacy services, focusing on integration, care coordination, medication management, and improving patient lives. The Clinical Pharmacy Services division manages the Banner formulary, develops system-wide clinical pharmacy services, and works on adverse drug event prevention. Banner Pharmacy Services aims to provide excellent patient care across the continuum through accessible, outcome-driven, and innovative pharmacy practices.
Requirements
- Licensed and registered pharmacy technician in the state of practice, where applicable. Incumbents in Arizona are also required to provide the AZ Board of Pharmacy Wallet Card at time of hire.
- Minimum of three years of healthcare and/or insurance/third party reimbursement experience required.
- One year of technician experience required.
- Strong customer service focus required.
- Superior problem-solving abilities required.
- Proficiency in Microsoft Word, Excel, network, web-based and payer applications required.
- Ability to anticipate customer requirements and meet those needs in an appropriate and timely manner is required.
- Ability to prioritize organization requirements and track progress of multiple initiatives.
Nice To Haves
- Completion of a Pharmacy Technician Certification Program.
- Associate’s or bachelor’s degree in business, healthcare or related field preferred.
- Prior authorization experience in specialty or retail pharmacy preferred.
- Knowledge of commercial, Medicare B, Medicare D and Medicaid pharmacy rules and regulations preferred.
- Knowledge and experience utilizing McKesson Enterprise, Cerner and Therigy preferred.
- Bi-lingual preferred.
- Additional related education and/or experience preferred.
Responsibilities
- Determine, support, and assist patients, provider teams, and the pharmacy department to overcome barriers to medication access, with a focus on third-party prior authorization and billing processes for pharmacy benefits.
- Assist patients with enrollment into grants and assistance programs, and communicate any financial responsibilities.
- Provide face-to-face, bedside-oriented service to offer comprehensive fiscal options to patients and provide medication cost information after transplant.
- Gather and effectively communicate medical and medication histories, including diagnosis, test results, lab values, and appropriate step therapy, to third parties for initial insurance approval.
- Verify eligibility and benefit provisions.
- Support the appeals process.
- Coordinate with stakeholders to remove medication access barriers.
- Maintain current knowledge of pharmacy regulations, payer agreements, and assistance programs.
- Provide timely medication benefit counseling to patients and hospital staff.
- Accurate and timely execution of pharmacy projects as required.
- Follow policies, procedures, and regulatory requirements and perform other work assignments.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
